MINNESOTA STATE UNIVERSITY (NPI# 1528438116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528438116 |
| Entity Type | Organization |
| Organization Name | MINNESOTA STATE UNIVERSITY |
| Other Organization Name | MSU SPORTS MEDICINE |
| Practice Address |
135 Myers Fieldhouse Mankato MN 56001-6171 |
| Mailing Address |
Po Box 650850 Dallas TX 75265-0850 |
| Practice Telephone | 5073892099 |
| Practice Fax Number | 9723673452 |
| Mailing Telephone | 8005559073 |
| Mailing Fax Number | 9723673451 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | MOUZON BASS III (OFFICE MANAGER) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MSU Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972683183 | Minnesota State University | Local Education Agency (LEA) | 3 Morris Hall, Dental Clinic, Mankato, MN 56001-6043 | 2006-10-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MINNESOTA STATE UNIVERSITY MOORHEAD | 1104 7th Ave S, Moorhead, MN 56563-0002 |
| System for Award Management (SAM) Entities | MINNESOTA STATE UNIVERSITY, MANKATO | 236 Wigley Administration Ctr, Mankato, MN 56001-6067 |
| Colorado Business Entities | Minnesota State University, Mankato Foundation, Inc. | 224 Alumni & Foundation Center, Mankato, MN 56001 |
| Street Address |
135 MYERS FIELDHOUSE |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-6171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427017375 | Sarah Merfeld Downey | Specialist/Technologist | 135 Myers Fieldhouse, Minnesota State University, Mankato, Mankato, MN 56001-6171 | 2006-03-20 |
| 1649637190 | Beverly Gruenzner | Specialist/Technologist | 135 Myers Fieldhouse, Minnesota State University Mankato, Mankato, MN 56001-6171 | 2016-01-27 |
| 1053532176 | Jeffrey Lee Chambers | Specialist/Technologist | 135 Myers Fieldhouse, Minnesota State University, Mankato, MN 56001-6171 | 2007-05-02 |
| 1386860757 | Kellie Riedl | Specialist/Technologist | 135 Myers Fieldhouse, Mankato, MN 56001-6171 | 2007-04-17 |
| 1174545180 | Jason Wade Bushie | Specialist/Technologist | 135 Myers Fieldhouse, Mankato, MN 56001-6171 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891767463 | Rochfort Wynn Kearney Jr. | Orthopaedic Surgery | 1431 Premier Dr, Mankato, MN 56001-6076 | 2006-02-07 |
| 1427021989 | Michael Mclean Kearney | Orthopaedic Surgery | 1431 Premier Drive, Mankato, MN 56001-6076 | 2006-02-07 |
| 1255690996 | Taylor R Beahrs | Orthopaedic Surgery | 1025 Marsh St, Mankato, MN 56001 | 2012-05-15 |
| 1154688208 | Michael Hendel | Orthopaedic Surgery | 1025 Marsh St, Mankato, MN 56001 | 2012-04-13 |
| 1861780942 | Eric Busse | Orthopaedic Surgery | 1025 Marsh St, Mankato, MN 56001-4752 | 2011-07-11 |
| 1265727937 | Andrew Ryan Mcnamara | Orthopaedic Surgery | 1431 Premier Dr, Mankato, MN 56001 | 2011-06-10 |
| 1760772099 | Jacob Daniel Ziegler | Orthopaedic Surgery | 1025 Marsh St, Mankato, MN 56001-4752 | 2011-04-07 |
| 1497066369 | Jacqueline Corona | Orthopaedic Surgery | 1025 Marsh St, Mankato, MN 56001 | 2010-06-25 |
| 1649408543 | Robert Freed | Orthopaedic Surgery | 1015 Marsh St, Mankato, MN 56001 | 2009-06-30 |
| 1508051079 | Ryan Patrick Foley | Orthopaedic Surgery | 1015 Marsh St, Mankato, MN 56001-4752 | 2007-09-07 |
| Find all providers in MANKATO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.