JEREMY GAGOLA (NPI# 1538603535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538603535 |
| Entity Type | Individual |
| Full Name | JEREMY GAGOLA |
| Credential | CNP |
| Practice Address |
203 4th St Nw Bagley MN 56621-8305 |
| Mailing Address |
2903 Johnson St Nw Bemidji MN 56601-4036 |
| Practice Telephone | 2186946501 |
| Mailing Telephone | 2184070585 |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2016-12-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP 4706 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
203 4TH ST NW |
| City | BAGLEY |
| State | MN |
| Zip Code | 56621-8305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558397232 | Clearwater Cnty Mem Hosp Phcy | Pharmacy | 203 4th St Nw, Bagley, MN 56621-8305 | 2006-06-24 |
| 1629633151 | Seth Tramm | Physician Assistant | 203 4th St Nw, Bagley, MN 56621-8305 | 2019-05-09 |
| 1134611544 | Patrick Wichmann | Nurse Practitioner | 203 4th St Nw, Bagley, MN 56621 | 2018-05-31 |
| 1932472255 | Sanford Health of Northern Minnesota | General Acute Care Hospital | 203 4th St Nw, Bagley, MN 56621-8305 | 2012-02-16 |
| 1861723330 | Brenda S. Wolf | Nurse Practitioner | 203 4th St Nw, Bagley, MN 56621-8305 | 2010-01-24 |
| 1457386906 | Michele Schoenborn | Nurse Practitioner | 203 4th St Nw, Bagley, MN 56621 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750933685 | Kristyn Faith Bergh | Physical Therapist | 118 Central Street West, Bagley, MN 56621 | 2019-07-11 |
| 1366956823 | Brian Sterling Paramore | Nurse Practitioner | 1656 Central Ave St W, Bagley, MN 56621 | 2017-11-20 |
| 1942436985 | Cornerstone Residence of Bagley, Inc | Assisted Living Facility | 30 Sunset Ave Sw, Bagley, MN 56621 | 2009-06-04 |
| 1548419708 | Melissa Nicole Jenson | Registered Nurse | 14 South Main Street, Bagley, MN 56621 | 2008-09-12 |
| 1518116813 | Tammy Rae Hanse | Registered Nurse | 14 South Main Ave, Bagley, MN 56621 | 2008-09-11 |
| 1134392350 | Kimberly Kae Crist | Lodging | 28647 Hwy 92, Bagley, MN 56621 | 2008-04-09 |
| 1952529323 | Clearwater Health Services | Skilled Nursing Facility | 416 7th St Ne, Bagley, MN 56621 | 2007-04-23 |
| 1295859411 | Clearwater County Memorial Hospital | General Acute Care Hospital | 203 4th St. N.w., Bagley, MN 56621 | 2007-03-16 |
| 1992875850 | Mary Elizabeth Jones | Dentist | 13 Main Avenue North, Bagley, MN 56621 | 2006-11-08 |
| 1558350678 | Bradley W Neujahr Od Pa | Optometrist | 14 2nd St Ne, Bagley, MN 56621 | 2005-10-20 |
| Find all providers in zip 56621 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366956823 | Brian Sterling Paramore | Nurse Practitioner | 1656 Central Ave St W, Bagley, MN 56621 | 2017-11-20 |
| 1699257261 | Janet Josephine Christianson | Nurse Practitioner | 1656 Central St W, Bagley, MN 56621-4357 | 2018-08-30 |
| 1134611544 | Patrick Wichmann | Nurse Practitioner | 203 4th St Nw, Bagley, MN 56621 | 2018-05-31 |
| 1861723330 | Brenda S. Wolf | Nurse Practitioner | 203 4th St Nw, Bagley, MN 56621-8305 | 2010-01-24 |
| 1942270673 | Bonnie Eck | Nurse Practitioner | 123 4th St Nw, Bagley, MN 56621-8306 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466368 | Amalia Jo Folland Harvey | Nurse Practitioner | 19883 Evensong Ct, Farmington, MN 55024-8688 | 2020-10-29 |
| 1710586235 | Jackelyn Laura Peterson | Nurse Practitioner | 10101 Bren Rd E Unit 345, Minnetonka, MN 55343-0060 | 2020-10-26 |
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1861091704 | Morgan Rohl | Nurse Practitioner | 117 12th Ave Nw Apt 2, Rochester, MN 55901-2787 | 2020-10-21 |
| 1063010304 | Kalie R Mccauley | Nurse Practitioner | 11452 Brook Rd Nw, Elk River, MN 55330-8739 | 2020-10-09 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1285231621 | Karlu Dorleh | Nurse Practitioner | 14151 Territorial Rd Unit 212, Maple Grove, MN 55369-5725 | 2020-10-08 |
| 1447857669 | Kimberly Dawn Bursch-tewalt | Nurse Practitioner | 11884 237th Ave Nw, Elk River, MN 55330-8255 | 2020-10-01 |
| 1639786312 | Peter Wahl | Nurse Practitioner | 4652 Lyndale Ave S, Minneapolis, MN 55419-5302 | 2020-09-28 |
| 1568078616 | Joanna Kay Rehm | Nurse Practitioner | 3025 Eagandale Pl Apt 338, Eagan, MN 55121-1236 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
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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.