FERGUS FALLS MEDICAL GROUP, P.A. (NPI# 1730127812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730127812 |
| Entity Type | Organization |
| Organization Name | FERGUS FALLS MEDICAL GROUP, P.A. |
| Other Organization Name | WESTRIDGE CLINIC |
| Practice Address |
2001 W Lincoln Ave Suite 56 Fergus Falls MN 56537-1010 |
| Mailing Address |
615 S Mill St Fergus Falls MN 56537-2756 |
| Practice Telephone | 2187395281 |
| Practice Fax Number | 2187395283 |
| Mailing Telephone | 2187392221 |
| Mailing Fax Number | 2187395501 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JIM WILKUS (CEO) |
| Authorized Official Telephone | 2187395281 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 44 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | WRC BCBS # | 62345FE | 01 |
| MN | WRC UCARE # | 109516 | 01 |
| ND | 10344 | 05 | |
| MN | WRC MEDICA # | 00-01587 | 01 |
| Other Name | Type Code |
|---|---|
| Westridge Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982649216 | Fergus Falls Medical Group, P.a. | Clinic/Center | 204 5th Street E, Herman, MN 56248-0304 | 2006-06-19 |
| 1750326070 | Fergus Falls Medical Group, P.a. | Clinic/Center | 404 West Broadway, Brown's Valley, MN 56219 | 2006-06-19 |
| 1376587972 | Fergus Falls Medical Group, P.a. | Clinic/Center | 410 Lake Ave S, Battle Lake, MN 56515 | 2006-06-15 |
| 1619915543 | Fergus Falls Medical Group, P.a. | Clinic/Center | 403 12th St N, Wheaton, MN 56296-1070 | 2006-06-03 |
| 1285676031 | Fergus Falls Medical Group, P.a. | Clinic/Center | 615 S Mill St, Fergus Falls, MN 56537-2756 | 2006-06-12 |
| 1134167166 | Fergus Falls Medical Group, P.a. | Clinic/Center | 405 Main St, Ashby, MN 56309-4659 | 2006-06-03 |
| Street Address |
2001 W LINCOLN AVE SUITE 56 |
| City | FERGUS FALLS |
| State | MN |
| Zip Code | 56537-1010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088466 | Alyssa Kristine Buckhouse | Dental Hygienist | 2001 W Lincoln Ave, Fergus Falls, MN 56537-1010 | 2020-06-17 |
| 1912410853 | Kaley Voltz | Dental Hygienist | 2001 W Lincoln Ave, Fergus Falls, MN 56537-1010 | 2017-11-14 |
| 1407282700 | Jesse Nease | Dentist | 2001 W Lincoln Ave, Suite 33, Fergus Falls, MN 56537-1010 | 2013-09-18 |
| 1598042376 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 2001 W Lincoln Ave, Suite 52, Fergus Falls, MN 56537-1010 | 2011-11-08 |
| 1871828152 | Apple Tree Dental | Dentist | 2001 W Lincoln Ave, Suite 33 - Westridge Mall, Fergus Falls, MN 56537-1010 | 2009-10-05 |
| 1841453347 | Mitchell C. Wellman | Dentist | 2001 W Lincoln Ave, Ste. 33, Fergus Falls, MN 56537-1010 | 2008-07-03 |
| 1215151089 | Michael J Andrews | Dentist | 2001 W Lincoln Ave, Suite #33, Fergus Falls, MN 56537-1010 | 2007-04-12 |
| 1427113984 | Stephanie Winrod | Optometrist | 2001 W Lincoln Ave, Fergus Falls, MN 56537-1010 | 2006-12-26 |
| 1225102882 | Meredith ----- Mellon | Dentist | 2001 W Lincoln Ave, Suite 33, Fergus Falls, MN 56537-1010 | 2006-11-17 |
| 1609955038 | Todd James Mcgovern | Dentist | 2001 W Lincoln Ave, Suite 33, Fergus Falls, MN 56537-1010 | 2006-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1336771591 | Paul George Wawin | Psychiatry & Neurology | 712 Cascade St. S. Lake Region Healthcare, Fergus Falls, MN 56537 | 2020-02-06 |
| 1134604127 | Christopher Michael Kjolhaug | Physical Therapist | 1131 South Mabelle Ave, Fergus Falls, MN 56537 | 2018-09-26 |
| 1619406808 | Aaron John Teigen | Physical Therapist | 1304 Lincoln Ave W, Suite C, Fergus Falls, MN 56537 | 2017-06-09 |
| 1003272154 | Anthony Gettel Dc LLC | Chiropractor | 755 Wildwood Trail, Fergus Falls, MN 56537 | 2016-01-05 |
| 1447628912 | Kelsey Shea | Student in an Organized Health Care Education/Training Program | 20743 Red Oak Dr., Fergus Falls, MN 56537 | 2015-09-14 |
| 1881070217 | Vineet Ganapati | Dentist | 2001 W Lincoln Ave # 33, Fergus Falls, MN 56537 | 2015-08-07 |
| 1497004832 | Beverly Renae Reiff | Registered Nurse | 22279 River Oaks Drive, Fergus Falls, MN 56537 | 2012-08-30 |
| 1114221421 | Jane Mary Bjornson | Social Worker | 21081 County Hwy 1, Fergus Falls, MN 56537 | 2010-12-29 |
| Find all providers in zip 56537 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578100806 | Matthew Ecker | Family Medicine | 2311 W Lincoln Ave, Fergus Falls, MN 56537-1064 | 2019-12-05 |
| 1891087573 | Mark T Vukonich | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537 | 2011-05-12 |
| 1790844009 | Gregory James Peterson | Family Medicine | 1505 Pebble Lake Rd, Suite 500, Fergus Falls, MN 56537-3800 | 2006-12-06 |
| 1437250800 | Robert A Vennerstrom | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-26 |
| 1801996715 | David J Sanderson Jr. | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-22 |
| 1356449227 | Patricia J. Lindholm | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-21 |
| 1831201979 | John Martin Thomas | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2006-08-31 |
| 1215044334 | Daniel L Lembcke | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-08-24 |
| 1841210259 | Wesley A Borowski | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-07-20 |
| 1134152879 | Christine Lynn Cabrera | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2006-07-08 |
| Find all providers in FERGUS FALLS | ||||
| City | FERGUS FALLS |
| Zip Code | 56537 |
Please comment or provide details below to improve the information on FERGUS FALLS MEDICAL GROUP, P.A..
| 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.