JACK GERARD SKENDZEL (NPI# 1760690580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760690580 |
| Entity Type | Individual |
| Full Name | JACK GERARD SKENDZEL |
| Credential | MD |
| Practice Address |
2090 Woodwinds Dr Woodbury MN 55125-2522 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685801 |
| Practice Fax Number | 6519685899 |
| Mailing Telephone | 6519685042 |
| Mailing Fax Number | 6519685904 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2015-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
57095 | MN | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
50769 | CO | Allopathic & Osteopathic Physicians |
| Street Address |
2090 WOODWINDS DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538137732 | Amy Stromwall Beacom | Emergency Medicine | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2006-03-14 |
| 1659928703 | Austin Moore | Physical Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-08-23 |
| 1962965848 | Molly Michelle Mullee | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-04-09 |
| 1306312814 | Sarah Renee Wittak | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-10-23 |
| 1124517677 | Joshua Allan Albarado | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-05-09 |
| 1013458009 | Abby Mohr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2017-03-10 |
| 1366898371 | William Thompson | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-05-09 |
| 1598125817 | Nathan L Reimnitz | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-29 |
| 1861851172 | Anthony J Sterk | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-15 |
| 1386025187 | Alex Villano | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2015-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770642530 | Jeffrey S Sider | Orthopaedic Surgery | 812 Woodbury Rd, Woodbury, NY 11797-2501 | 2006-12-07 |
| 1386007417 | Summit Orthopedics, Ltd | Orthopaedic Surgery | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2016-04-05 |
| 1316101447 | James Michael Paci | Orthopaedic Surgery | 45 Crossways Park Dr W, Woodbury, NY 11797-2002 | 2008-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699388447 | Erik Therrien | Orthopaedic Surgery | Mayo Clinic 200 1st St Sw Rochester Mn 55905, Rochester, MN 55905-0001 | 2020-08-30 |
| 1619950839 | Bradley James Nelson | Orthopaedic Surgery | 2512 S 7th St, Department of Orthopaedics, R200, Minneapolis, MN 55454-1404 | 2005-11-22 |
| 1902381148 | Richard Kyle Maciver Martin | Orthopaedic Surgery | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-10-02 |
| 1174008288 | Maen Abou-ghaida | Orthopaedic Surgery | 323 S Minnesota St, Crookston, MN 56716-1601 | 2018-09-25 |
| 1821502154 | Michael Blake Jacob | Orthopaedic Surgery | 2855 Campus Dr, Plymouth, MN 55441-2649 | 2017-11-22 |
| 1528438116 | Minnesota State University | Orthopaedic Surgery | 135 Myers Fieldhouse, Mankato, MN 56001-6171 | 2015-09-25 |
| 1851705057 | Jonathan James Harvey | Orthopaedic Surgery | 111 17th Ave E Ste 101, Alexandria, MN 56308-5274 | 2014-06-16 |
| 1861802019 | Adam Morgan Johannsen | Orthopaedic Surgery | 14000 Fairview Dr, Burnsville, MN 55337-5713 | 2014-04-28 |
| 1508156571 | Ryan Robert Fader | Orthopaedic Surgery | 8100 W 78th St Ste 225, Edina, MN 55439-2569 | 2011-04-12 |
| 1396056842 | Zachary Peter Arntson | Orthopaedic Surgery | 8540 Quaday Ave Ne, Otsego, MN 55330-6522 | 2010-06-30 |
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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.