PHILIP BRUCE IMHOLTE (NPI# 1760604623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760604623 |
Entity Type | Individual |
Full Name | PHILIP BRUCE IMHOLTE |
Credential | M.D. |
Practice Address |
1601 Golf Course Road Grand Rapids MN 55744 |
Practice Telephone | 2183265000 |
Practice Fax Number | 2189991380 |
Mailing Telephone | 2183265000 |
Mailing Fax Number | 2189991380 |
Enumeration Date | 2007-05-02 |
Last Update Date | 2010-10-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 49754 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
RR MEDICARE PTAN | P00438363 | 01 | |
MN | 244940000 | 05 | |
MEDICA | 1760604623 | 01 | |
MN | BCBS | 17P85IM | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740821214 | Philip David Imholte | Counselor | 77 Mill St, Westfield, MA 01085-4598 | 2019-10-04 |
Street Address |
1601 GOLF COURSE ROAD |
City | GRAND RAPIDS |
State | MN |
Zip Code | 55744 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972596823 | Russell K Lawson | Urology | 1601 Golf Course Road, Grand Rapids, MN 55744 | 2005-08-25 |
1992129985 | Heather Ann Swanson-hill | Nurse Practitioner | 1601 Golf Course Road, Grand Itasca Clinic & Hospital, Grand Rapids, MN 55744 | 2014-02-11 |
1831448232 | Dawn Marie Olson | Nurse Practitioner | 1601 Golf Course Road, Grand Rapids, MN 55744 | 2012-08-31 |
1174753313 | Daniel William Brody | Internal Medicine | 1601 Golf Course Road, Grand Rapids, MN 55744 | 2009-07-22 |
1235398751 | Ryan Thayer Novak | Urology | 1601 Golf Course Road, Grand Rapids, MN 55744-8648 | 2008-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
Find all providers in zip 55744 |
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 |
---|---|---|---|---|
1083239974 | Mercy Health Partners | Family Medicine | 826 Parchment Dr Se Ste 210, Grand Rapids, MI 49546-2307 | 2020-06-16 |
1740810563 | Spectrum Health Primary Care Partners | Family Medicine | 435 Ionia Ave Sw, Grand Rapids, MI 49503-5161 | 2020-01-21 |
1932748050 | Alexander Corcoran Pa-c LLC | Family Medicine | 2340 College Ave Se, Grand Rapids, MI 49507-3108 | 2020-01-06 |
1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
1619463775 | Zlex, Pllc | Family Medicine | 847 Parchment Dr Se Ste 100, Grand Rapids, MI 49546-2303 | 2018-07-02 |
1558856518 | Leland Cary Gyr | Family Medicine | 25 Michigan St Ne Ste 5300, Grand Rapids, MI 49503-2515 | 2018-06-22 |
1982126355 | Jeffrey Dufresne | Family Medicine | 300 Lafayette Ave. Se, Grand Rapids, MI 49503 | 2017-07-07 |
1386165157 | Samantha V Mcpharlin | Family Medicine | 300 Lafayette Ave Se Ste 400, Grand Rapids, MI 49503 | 2017-07-03 |
1639699481 | Andrew R Izzo | Family Medicine | 3200 Eagle Park Dr Ne Ste 102, Grand Rapids, MI 49525-7057 | 2017-06-22 |
1871908970 | Marc Arenas | Family Medicine | 245 Cherry St Se Ste 200, Grand Rapids, MI 49503 | 2014-06-26 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 55744 |
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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.