BLAKE NOENNIG (NPI# 1699192997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699192997 |
| Entity Type | Individual |
| Full Name | BLAKE NOENNIG |
| Practice Address |
3800 Park Nicollet Blvd St Louis Park MN 55416 |
| Mailing Address |
3800 Park Nicollet Blvd St Louis Park MN 55416-2527 |
| Practice Telephone | 9529933123 |
| Practice Fax Number | 9529933286 |
| Mailing Telephone | 9529933123 |
| Mailing Fax Number | 9529933286 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2019-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 65775 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Sw Archer Rd, Rm N-203, Gainesville, FL 326100247 | 3522738634 |
| Street Address |
3800 PARK NICOLLET BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497745 | Mary C Fields | Psychiatry & Neurology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-06-16 |
| 1316552383 | Emily Elizabeth Morimoto | Psychologist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-09-15 |
| 1245862846 | Caara Hirsch Leintz | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-02-11 |
| 1477102770 | Kyja Foster | Counselor | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-09-09 |
| 1750938411 | Abigale Jayne Harris | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-19 |
| 1912552076 | Michael Patrick Miller | Dietitian, Registered | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-06 |
| 1083277743 | Jessica B Arndt | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-04-18 |
| 1043785157 | Jerry L Juhl | Physical Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-05 |
| 1437624558 | Chandler Elise Domian Ommen | Occupational Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-04 |
| 1861977472 | Sarah Ruth Tupper | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-09-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609040856 | Urology Associates, Ltd | Urology | 6490 Excelsior Blvd, Suite E202, St Louis Park, MN 55426-4705 | 2008-04-18 |
| 1558310821 | Nathan B Hoffman | Urology | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2006-05-06 |
| 1548248479 | Daniel Zapzalka | Urology | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2005-12-30 |
| 1447238373 | Gang Zhang | Urology | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2005-12-30 |
| 1154308757 | William C Sharer | Urology | 3900 Park Nicollet Blvd, Park Nicollet Clinic - Slp, St Louis Park, MN 55416-2503 | 2005-12-27 |
| 1356324818 | Sharon M Hepler | Urology | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939286 | Joseph Marconni Sewell Araya | Urology | 11920 Baypoint Dr, Burnsville, MN 55337-3367 | 2020-10-12 |
| 1922599737 | Subodh Kumar Regmi | Urology | Department of Urology, University of Minnesoata, 420 Delaware St S.e., Mmc 394, Minneapolis, MN 55455 | 2018-05-29 |
| 1700281953 | Centracare Clinic | Urology | 2351 Connecticut Ave S, Suite 200, Centracare Clinic- Adult & Pediatric Urology, Sartell, MN 56377-2477 | 2014-10-30 |
| 1154734127 | Abhinav Khanna | Urology | 200 First Street Nw, Rochester, MN 55905-0001 | 2014-06-08 |
| 1427476662 | Khushabu Kasabwala | Urology | 420 Delaware St. S. E., Mmc 394, Minneapolis, MN 55455 | 2014-04-04 |
| 1518302181 | Daniel Liberman | Urology | 420 Delaware Stre Se, Suite B435, Institute for Prostrate and Urologic Cancers, Minneapolis, MN 55455-0341 | 2013-05-08 |
| 1386981637 | Urology Associates, Ltd. | Urology | 244 7th Street North, Mora, MN 55051 | 2013-01-07 |
| 1831445691 | Urology Associates, Ltd. | Urology | 111 Hundertmark Rd Ste 410, 212 Medical Building, Chaska, MN 55318-1458 | 2012-07-31 |
| 1841590593 | Hakim Medical Enterprises, P.a. | Urology | 2963 Fairchild Ave, Wayzata, MN 55391-2956 | 2010-10-28 |
| 1164747085 | Joseph Robert Nelson Zabell | Urology | 6363 France Ave S Ste 500, Edina, MN 55435-2135 | 2010-04-03 |
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| City | ST LOUIS PARK |
| Zip Code | 55416 |
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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.