DERMATOLOGY PROFESSIONALS, PA (NPI# 1720269426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720269426 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY PROFESSIONALS, PA |
| Practice Address |
13359 Isle Dr Ste 3 Baxter MN 56425 |
| Practice Telephone | 2184547546 |
| Mailing Telephone | 2184547546 |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | PAUL B LUNDSTROM (PRESIDENT) |
| Authorized Official Telephone | 2184547546 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 45453 | MN | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356714182 | Dermatology Professionals, Pa | Clinic/Center | 2300 24th St Nw, Suite 110, Bemidji, MN 56601-6379 | 2015-11-02 |
| Street Address |
13359 ISLE DR STE 3 |
| City | BAXTER |
| State | MN |
| Zip Code | 56425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699759647 | Paul Lundstrom | Dermatology | 13359 Isle Dr, Suite 3, Baxter, MN 56425-2222 | 2005-12-02 |
| 1265583652 | Kurtis A. Waters, M.d., P.a. | Otolaryngology | 13359 Isle Dr, Suite 1, Baxter, MN 56425-2221 | 2007-01-15 |
| 1821180712 | Nicole Therese Manecke | Physician Assistant | 13359 Isle Dr, Suite 3, Baxter, MN 56425-2222 | 2006-09-28 |
| 1568440717 | Kurtis Allen Waters | Otolaryngology | 13359 Isle Dr, Suite 1, Baxter, MN 56425-2221 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396364089 | Jennifer Ann Olson | Behavioral Analyst | Autism Matters 14387 Edgewood Drive, Baxter, MN 56425 | 2020-04-13 |
| 1801229000 | Longville Lakes Clinic, Inc. | Clinic/Center | 13205 Isle Drive, Baxter, MN 56425 | 2013-08-12 |
| 1033555867 | Shiela Klemmetsen | Family Medicine | Essentia Health St. Joseph's-baxter Clinic, 13060 Isle Drive, Baxter, MN 56425 | 2013-05-20 |
| 1053547299 | Linda Marie Bowman | Social Worker | 13397 Shadow Wood Drive, Baxter, MN 56425 | 2009-06-02 |
| 1215112792 | Brainerd Medical Center, Inc. | Nurse Practitioner | 14133 Edgewood Drive, Baxter, MN 56425 | 2008-01-03 |
| 1134313208 | Sleep Center of Central Minnesota LLC | Clinic/Center | 13495 Elder Drive, Suite 120, Baxter, MN 56425 | 2007-08-31 |
| 1750582482 | Jacqueline Elizabeth Oelfke | Nurse Practitioner | Cbhh-baxter, 14241 Grand Oaks Dr., Baxter, MN 56425 | 2007-05-30 |
| 1508080631 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14398 Grand Oaks Drive, Baxter, MN 56425 | 2007-04-12 |
| 1093842247 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14396 Grand Oaks Dr, Baxter, MN 56425 | 2007-02-27 |
| 1053458364 | Teri Kaminski Peterson | Speech-Language Pathologist | 15620 Edgewood Dr Ste 240, Baxter, MN 56425 | 2007-01-30 |
| Find all providers in zip 56425 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801229000 | Longville Lakes Clinic, Inc. | Clinic/Center | 13205 Isle Drive, Baxter, MN 56425 | 2013-08-12 |
| 1003302423 | Upper Cumberland Medical Clinic, Inc. | Clinic/Center | 319 Broad St, Baxter, TN 38544-5117 | 2018-07-09 |
| 1598165052 | True North Counseling and Consulting | Clinic/Center | 13432 Elmwood Dr Ste 209, Baxter, MN 56425-8538 | 2014-09-02 |
| 1306196548 | Dermatology Professionals Pa | Clinic/Center | 15167 Edgewood Dr, Suite 200, Baxter, MN 56401-6946 | 2012-09-14 |
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|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 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.