DR. KENNETH ROBERT ELDRIDGE (NPI# 1740208875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740208875 |
| Entity Type | Individual |
| Full Name | DR. KENNETH ROBERT ELDRIDGE |
| Credential | M.D. |
| Practice Address |
1216 Ryans Rd Worthington MN 56187-1722 |
| Practice Telephone | 5073722921 |
| Practice Fax Number | 5073725789 |
| Mailing Telephone | 5073722921 |
| Mailing Fax Number | 5073725789 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 52204 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G-296930 | 05 |
| Street Address |
1216 RYANS RD |
| City | WORTHINGTON |
| State | MN |
| Zip Code | 56187-1722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306839022 | Benjamin Ernest Gaines | Obstetrics & Gynecology | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2005-08-28 |
| 1891335311 | Efrain Ocegueda | Dietitian, Registered | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2020-01-13 |
| 1629632443 | Debra Kay Behrends | Registered Nurse | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2019-04-26 |
| 1730563404 | Amir Makhmalbaf | Internal Medicine | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2015-07-13 |
| 1629472964 | Victoria Blanchette | Nurse Practitioner | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2014-10-15 |
| 1801226188 | Kristal Grigsby | Social Worker | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2013-11-22 |
| 1679826465 | Darlene Renee Dewitt | Dietitian, Registered | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2012-10-18 |
| 1922357839 | Avera Mckennan | Clinic/Center | 1216 Ryans Rd, Suite 2, Worthington, MN 56187-1722 | 2012-09-06 |
| 1609135367 | Katherine Elizabeth Smidt | Advanced Practice Midwife | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2012-05-15 |
| 1821319344 | Syed Asad Shah | Family Medicine | 1216 Ryans Rd, Worthington, MN 56187-1722 | 2010-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1912216540 | Nobles County Jail | Clinic/Center | 1530 Airport Road, Worthington, MN 56187 | 2010-09-30 |
| 1306984539 | Edward Thomas Mcniece | Dentist | 1027 Second Ave, Worthington, MN 56187 | 2007-02-01 |
| 1053338780 | Diagnostic Radiologic Imaging Pa | Radiology | 1607 N Mcmillan St, Ste 1, Worthington, MN 56187 | 2006-07-17 |
| 1427014232 | Scott James Hoffman | Podiatrist | 1205 Ryans Road, Worthington, MN 56187 | 2006-04-21 |
| 1588654404 | Jason Coy Turner | Pharmacist | 511 10th St, Worthington, MN 56187 | 2005-10-22 |
| 1518433879 | Nicole Block | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187 | 2018-10-15 |
| 1033423322 | Rachael R Dekker | Nurse Practitioner | 1018 6th Ave, Worthington, MN 56187 | 2010-07-29 |
| 1417196601 | Jonathan Gabriel Eli-phillips | Obstetrics & Gynecology | 1018 6th Ave, Worthington, MN 56187 | 2009-02-11 |
| 1174716245 | Sanford Clinic | Radiology | 1018 6th Ave, Worthington, MN 56187 | 2007-08-22 |
| Find all providers in zip 56187 | ||||
| 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 |
|---|---|---|---|---|
| 1851911440 | Interim Healthcare Palliative Care of The Midwest, Inc | Family Medicine | 300 W Wilson Bridge Rd Ste 250, Worthington, OH 43085-2289 | 2020-04-23 |
| 1548618267 | Chelsea Fu | Family Medicine | 160 W Wilson Bridge Rd Ste 100, Worthington, OH 43085-2676 | 2016-06-03 |
| 1215317375 | Rural Health Care, Inc. | Family Medicine | 1216 Ryans Rd Ste 3, Worthington, MN 56187-1781 | 2015-06-04 |
| 1578700829 | Bernard F Master | Family Medicine | 340 Tucker Dr, Worthington, OH 43085-3030 | 2009-01-08 |
| 1487804647 | Marie Nancy Dilauro | Family Medicine | 47 E Wilson Bridge Rd, Worthington, OH 43085-2357 | 2008-09-24 |
| 1891974556 | Worthington Medical Center | Family Medicine | 6565 Worthington Galena Rd Ste B205, Worthington, OH 43085-2668 | 2007-10-30 |
| 1669685004 | Jennifer Ellen Hetrick | Family Medicine | 885 High St Ste 107, Worthington, OH 43085-4158 | 2007-05-08 |
| 1922163161 | Kristin L Oaks Do Inc | Family Medicine | 933 High St Ste 116, Worthington, OH 43085-4046 | 2006-12-27 |
| 1437259371 | Joyce Witkiewicz-bowser | Family Medicine | 1482 Butler Rd, Worthington, PA 16262-9601 | 2006-09-22 |
| 1932123007 | Joseph Edward Kearns | Family Medicine | 6777 Hayhurst St, Worthington, OH 43085-2527 | 2006-07-26 |
| Find all providers in WORTHINGTON | ||||
| City | WORTHINGTON |
| Zip Code | 56187 |
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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.