JOHN D MISCHKE (NPI# 1609878446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609878446 |
| Entity Type | Individual |
| Full Name | JOHN D MISCHKE |
| Credential | MD |
| Practice Address |
1200 6th Ave N Saint Cloud MN 56303-2735 |
| Practice Telephone | 3202525131 |
| Practice Fax Number | 3202402118 |
| Mailing Telephone | 3202525131 |
| Mailing Fax Number | 3202402118 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35762 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICA HEALTH PLANS | 0300171 | 01 | |
| MMSI | 10-22-2001 | 01 | |
| ARAZ GROUP/AMERICA'S PPO | 1451002 | 01 | |
| PREFERRED ONE | 1028918 | 01 | |
| BCBS | 58F40MI | 01 | |
| FIRST HEALTH PLAN | 2119215 | 01 | |
| HEALTH PARTNERS | HP13991 | 01 | |
| U-CARE | 141074 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972880953 | John Jacob Mischke | Physical Therapist | 4920 S 30th St, Suite 103, Omaha, NE 68107-1590 | 2011-11-04 |
| 1912066952 | John Bernard Mischke | Psychologist | 821 Raymond Ave, Suite 300, Saint Paul, MN 55114-1503 | 2006-12-06 |
| Street Address |
1200 6TH AVE N |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805518 | Paul Charles Peterson | Emergency Medicine | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-07-15 |
| 1871127290 | Kayla Girgen | Dietitian, Registered | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2020-02-25 |
| 1023640034 | Faith Kelly Dammann | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2020-02-07 |
| 1538707377 | Alissa Wigen | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-12-11 |
| 1639713290 | Jordan Lajoie | Nurse Practitioner | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-11-06 |
| 1528602430 | Hannah Elise Osterndorf | Dietitian, Registered | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-11-04 |
| 1558919100 | Mergitu Megersa Gemeda | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2019-08-27 |
| 1659927879 | Jennifer Marie Bretscher | Physician Assistant | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2019-08-13 |
| 1366094302 | Laura Verley | Registered Nurse | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2019-07-10 |
| 1063074235 | Briana Gray | Pharmacist | 1200 6th Ave N, Internal Medicine, Saint Cloud, MN 56303-2735 | 2019-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811092398 | Midwest Clinic of Dermatology Laser and Cosmetic Surgery Pa | Dermatology | 1510 24th Ave N, Saint Cloud, MN 56303-1304 | 2006-09-13 |
| 1891778163 | Daniel Kevin Elieff | Dermatology | 1510 24th Ave N, Saint Cloud, MN 56303-1304 | 2005-11-21 |
| 1053313692 | Christina K Anderson | Dermatology | 1200 6th Ave N, Saint Cloud, MN 56303-2735 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962871608 | Lakes Dermatology, Pa | Dermatology | 14305 Southcross Dr W, Suite 110, Burnsville, MN 55306-7009 | 2015-09-23 |
| 1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
| 1578982773 | Lori Ann Fiessinger | Dermatology | 420 Delaware Street Se, Mmc 98, Minneapolis, MN 55455 | 2014-04-15 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1033537782 | Erin Sellinger | Dermatology | 2 Carlson Pkwy N, Ste 240, Plymouth, MN 55447-4485 | 2014-03-31 |
| 1033555230 | Samuel Blake Ecker | Dermatology | 3655 Plymouth Blvd Ste 110, Minneapolis, MN 55446-3665 | 2013-05-14 |
| 1295078913 | Jessica Jane Newman | Dermatology | 4-240, Phillips-wangensteen Bldg., 516 Delaware Street S.e., Mail Code 98, Minneapolis, MN 55455 | 2013-04-01 |
| 1437416088 | Tiffany Lynn Shih | Dermatology | 401 Phalen Blvd # Ms 41102b, Saint Paul, MN 55130-5302 | 2012-04-20 |
| 1124317383 | Sara Anne Hylwa | Dermatology | 730 South 8th Street, Department of Dermatology, Minneapolis, MN 55415 | 2011-03-28 |
| 1770885360 | Thomas Joseph Kalb | Dermatology | 13420 106th St., Young America, MN 55397-5401 | 2010-12-02 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.