DEREK SWOBODA (NPI# 1720432479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720432479 |
| Entity Type | Individual |
| Full Name | DEREK SWOBODA |
| Credential | ATC, LAT, SPT |
| Practice Address |
710 8th St N Mountain Lake MN 56159-1308 |
| Practice Telephone | 5078220491 |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
710 8TH ST N |
| City | MOUNTAIN LAKE |
| State | MN |
| Zip Code | 56159-1308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235299066 | City of Mountain Lake | Ambulance | 1100 11th Avenue, Mountain Lake, MN 56159 | 2006-12-11 |
| 1700977246 | Schneider Drug | Pharmacist | 113 East Brown, Comfrey, MN 56159 | 2006-09-28 |
| 1265423990 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 745 Basinger Memorial Dr, Mountain Lake, MN 56159-1312 | 2005-11-02 |
| 1750622908 | Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 603 7th Ave, Mountain Lake, MN 56159-1333 | 2013-03-13 |
| 1568469039 | Sanford Clinic | Clinic/Center | 308 8th St N, Mountain Lake, MN 56159-1568 | 2005-06-30 |
| 1902323405 | Megan Sharon Pohlman | Physician Assistant | 308 8th St N, Mountain Lake, MN 56159-1568 | 2017-08-25 |
| 1215091145 | Sioux Valley Clinic | Clinic/Center | 308 8th St N, Mountain Lake, MN 56159-1568 | 2006-12-22 |
| 1275530750 | Steven M Harder | Family Medicine | 308 8th St N, Mountain Lake, MN 56159-1568 | 2005-06-30 |
| 1508177890 | Avera Marshall | Ophthalmology | 1040 3rd Ave, Mountain Lake, MN 56159-1587 | 2010-07-01 |
| 1619958279 | Vernon Elliott Peterson | Pharmacist | 1007 3rd Ave, Mountain Lake, MN 56159-1587 | 2005-11-10 |
| Find all providers in zip 56159 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092165 | Jamie Lynn Erickson | Specialist/Technologist | 43628 374th Ln, Aitkin, MN 56431-4027 | 2020-10-27 |
| 1760082044 | Craig Daniel Merten | Specialist/Technologist | 5045 Division Ave # 5575, White Bear Lake, MN 55110-2663 | 2020-10-27 |
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1851906887 | Teddy Ray Gildersleeve | Specialist/Technologist | 37320 Oriole Ave, Lindstrom, MN 55045-9109 | 2020-09-15 |
| 1851906697 | Tadd William Berg | Specialist/Technologist | 2415 W 9th St, Duluth, MN 55806-1150 | 2020-09-09 |
| 1952916793 | Megan Marie Hautajarvi | Specialist/Technologist | 2536 Peace Dr, Duluth, MN 55811-2971 | 2020-09-09 |
| 1871108795 | Bryce Mershon Beamish | Specialist/Technologist | 3501 Lowell St, Wayzata, MN 55391-3411 | 2020-09-09 |
| 1043825961 | Kevin Eskuri | Specialist/Technologist | 8090 172nd St W, Lakeville, MN 55044-6206 | 2020-09-09 |
| 1952916876 | Elizabeth Marie Altendorf | Specialist/Technologist | 1621 397th Ave Ne, Stanchfield, MN 55080-3303 | 2020-09-09 |
| 1699380519 | Kourtney Jean Palmi | Specialist/Technologist | 4922 Howard Gnesen Rd, Duluth, MN 55803-2710 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN LAKE |
| Zip Code | 56159 |
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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.