SUSAN ELIZABETH STARK (NPI# 1598105694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598105694 |
| Entity Type | Individual |
| Full Name | SUSAN ELIZABETH STARK |
| Practice Address |
5211 Highway 110 Essentia Heatlh Northern Pines Clinic Aurora MN 55705-1522 |
| Mailing Address |
5211 Highway 110 Essentia Health Northern Pines Clinic Aurora MN 55705-1522 |
| Practice Telephone | 2182293311 |
| Mailing Telephone | 2182293311 |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2013-10-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R153102-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1598105694 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013974666 | Susan D Stark | Social Worker | 909 Union St, Brooklyn, NY 11215-1465 | 2006-04-27 |
| 1912473497 | Susan Stark | Occupational Therapist | 5201 Pattison Ave, Saint Louis, MO 63110-2041 | 2018-10-22 |
| 1396283644 | Susan Stark | Social Worker | 595 W End Ave, Apt. 11b, New York, NY 10024-1727 | 2017-02-07 |
| 1083885800 | Susan E Stark | Pharmacist | 5510 Howard St, Skokie, IL 60077-2620 | 2008-03-19 |
| 1013102722 | Susan Audrey Stark | Dietitian, Registered | 3459 5th Ave, Pittsburgh, PA 15213-3236 | 2007-09-06 |
| Street Address |
5211 HIGHWAY 110 ESSENTIA HEATLH NORTHERN PINES CLINIC |
| City | AURORA |
| State | MN |
| Zip Code | 55705-1522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043285455 | Catherine Marie Mitchell | Family Medicine | 5211 Highway 110, Essentia Health Northern Pines Clinic, Aurora, MN 55705-1522 | 2006-02-20 |
| 1174024095 | Mallory Ellen Imberg | Speech-Language Pathologist | 5211 Highway 110, Aurora, MN 55705-1522 | 2018-02-26 |
| 1285183046 | Northern Pines Medical Center | Clinic/Center | 5211 Highway 110, Aurora, MN 55705-1522 | 2016-09-22 |
| 1932573177 | Emily Elizabeth Modin | Occupational Therapist | 5211 Highway 110, Aurora, MN 55705-1522 | 2015-11-28 |
| 1215321310 | Angela Boyd | Dietitian, Registered | 5211 Highway 110, Aurora, MN 55705-1522 | 2015-03-26 |
| 1497169056 | Tracy Powell | Registered Nurse | 5211 Highway 110, Aurora, MN 55705-1522 | 2014-06-11 |
| 1225467004 | Justin Peyla | Physical Therapist | 5211 Highway 110, Essentia Health-northern Pines, Aurora, MN 55705-1522 | 2013-11-02 |
| 1902243280 | Northern Pines Medical Center | Medicare Defined Swing Bed Unit | 5211 Highway 110, Aurora, MN 55705-1522 | 2013-05-28 |
| 1881954147 | Northern Pines Medical Center | Clinic/Center | 5211 Highway 110, Aurora, MN 55705-1522 | 2012-05-21 |
| 1891053567 | Northern Pines Medical Center | Non-Pharmacy Dispensing Site | 5211 Highway 110, Aurora, MN 55705-1522 | 2012-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144436189 | Mary Agnes Johnson | Technician | 705 Knuti Dr, Aurora, MN 55705 | 2007-05-15 |
| 1871651646 | Northern Pines Medical Center | Pharmacy | 5211 Hwy 110, Aurora, MN 55705 | 2006-12-05 |
| 1700997327 | Mark W Boback | Dentist | 22 W 3rd Ave N, Aurora, MN 55705 | 2006-08-31 |
| 1346252053 | Claude Erickson | Physician Assistant | 405 West 3rd Ave N, Aurora, MN 55705 | 2006-08-12 |
| 1780838151 | Vision Pro | Optometrist | 5211 Hwy 110, White Community Hospital, Aurora, MN 55705 | 2008-11-11 |
| 1982641791 | The Duluth Clinic, Ltd | Clinic/Center | 405 W 3rd Ave N, Box 392, Aurora, MN 55705-1247 | 2006-06-01 |
| 1447817978 | Mesabacare LLC | Counselor | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2019-05-21 |
| 1063704930 | Ann Marie Westbrook Vreeland | Nurse Practitioner | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2011-05-10 |
| 1811920564 | Michelle Renee Oman | Family Medicine | 405 W 3rd Ave N, Aurora, MN 55705-1247 | 2006-07-08 |
| 1457958498 | Carol Ruth Haasl | Community Health Worker | 215 W 4th Ave N, Aurora, MN 55705-1252 | 2020-10-02 |
| Find all providers in zip 55705 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466855 | Cassandra Elizabeth Saad | Nurse Practitioner | 4024 S Rifle Way, Aurora, CO 80013-3240 | 2020-10-27 |
| 1992304471 | Amanda Michelle Heibult | Nurse Practitioner | 22047 E Ridge Trail Dr, Aurora, CO 80016-2668 | 2020-10-26 |
| 1902405038 | Rosalind Daninger | Nurse Practitioner | 1390 S Potomac St Ste 128, Aurora, CO 80012-4529 | 2020-10-20 |
| 1942817408 | Salwa Mourtada Bamba | Nurse Practitioner | University of Colorado Medicine, 12631 East 17th Avenue, Aurora, CO 80045 | 2020-09-29 |
| 1841807617 | Kanwal Jiwani | Nurse Practitioner | 2670 Clara Ave, Aurora, IL 60502-9653 | 2020-09-25 |
| 1336757384 | Angela Kay Savage | Nurse Practitioner | 2600 S Parker Rd Unit 2, Aurora, CO 80014-1613 | 2020-07-15 |
| 1700403029 | Peter M Quansah | Nurse Practitioner | 25204 E Byers Dr, Aurora, CO 80018-4661 | 2020-07-02 |
| 1427674654 | Megan D Edwards | Nurse Practitioner | 2600 S Parker Rd Bldg 2-120, Aurora, CO 80014-1613 | 2020-06-23 |
| 1720602097 | Sofia Figueroa | Nurse Practitioner | 157 S Lincoln Ave Ste K, Aurora, IL 60505-4291 | 2020-06-02 |
| 1588290456 | Andrea Holmes | Nurse Practitioner | 9982 Windjammer Trl, Aurora, OH 44202-9026 | 2020-03-23 |
| Find all providers in AURORA | ||||
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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.