DR. ETHAN LEE SKOG (NPI# 1811486459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811486459 |
| Entity Type | Individual |
| Full Name | DR. ETHAN LEE SKOG |
| Credential | DC |
| Practice Address |
4900 Highway 169 N Ste 301 New Hope MN 55428-4019 |
| Practice Telephone | 7634967871 |
| Mailing Telephone | 7634967871 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2020-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 6473 | MN | Chiropractic Providers |
| Street Address |
4900 HIGHWAY 169 N STE 301 |
| City | NEW HOPE |
| State | MN |
| Zip Code | 55428-4019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807813 | S Group PC | Chiropractor | 4900 Highway 169 N Ste 301, New Hope, MN 55428-4019 | 2019-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940025 | Gerard Idrissa Omari | Registered Nurse | 5844 Jersey Avenue North, Crystal, MN 55428 | 2020-01-06 |
| 1538706726 | Mary Sue Wester | Preventive Medicine | 6101 Virginia Ave. N, New Hope, MN 55428 | 2019-12-06 |
| 1194237479 | Stacy Shrestha | Nurse Practitioner | 7100 Northland Circle N, Ste 119, Brooklyn Park, MN 55428 | 2017-10-26 |
| 1023537115 | Cynthia Mcquade-brinkman | Massage Therapist | 6617 Jersey Ave N, Brooklyn Park, MN 55428 | 2017-09-11 |
| 1255792818 | Sadiya Ali | Non-emergency Medical Transport (VAN) | 7164 72nd Lane N Apt 244, Brooklyn Park, MN 55428 | 2016-03-10 |
| 1962867606 | Heart Felt Home Health Care Inc. | Home Health | 36 Fremont St., Lowell, MA 55428 | 2015-12-23 |
| 1992126155 | North Memorial Health Care | Clinic/Center | 8100 42nd Avenue North, New Hope, MN 55428 | 2013-12-13 |
| 1508105370 | Guardian Home Health Care LLC | Home Health | 6708 Dutton Ave N, Brooklyn Park, MN 55428 | 2013-02-13 |
| 1265709182 | Mark David Wermers | Pharmacist | 4200 Winnetka Ave, New Hope, MN 55428 | 2011-11-21 |
| 1841424868 | Cozy Clalm LLC | Durable Medical Equipment & Medical Supplies | 6616 Hillsboro Ave N, Brooklyn Park, MN 55428 | 2009-05-05 |
| Find all providers in zip 55428 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962023044 | Alison Jade Osowski | Chiropractor | 4900 Highway 169 N Ste 324, New Hope, MN 55428-4046 | 2020-04-30 |
| 1366073827 | Justin B Marty | Chiropractor | 4900 Highway 169 N Ste 250, New Hope, MN 55428-4019 | 2020-02-03 |
| 1104383058 | Meridian Chiropractic, Inc | Chiropractor | 4900 Highway 169 N # 250, New Hope, MN 55428-4058 | 2019-02-27 |
| 1376017376 | Heather Sara Smith | Chiropractor | 4900 Highway 169 N Ste 205, New Hope, MN 55428-4017 | 2019-01-14 |
| 1336675230 | Samuel Ovid Rinehart | Chiropractor | 9405 36th Ave N Ste B, New Hope, MN 55427-1776 | 2017-05-11 |
| 1346645348 | Tom Bomberg | Chiropractor | 3410 Winnetka Ave N Ste 100, New Hope, MN 55427-2091 | 2014-11-03 |
| 1427354877 | Woudsma Worth Chiropractic Associates | Chiropractor | 2101 Street Road, New Hope, PA 18938 | 2011-02-02 |
| 1982816245 | Lori R Tenenbaum | Chiropractor | 4124 Quebec Ave N Ste 207, New Hope, MN 55427-1240 | 2007-05-07 |
| 1801926787 | David A. D'angelo | Chiropractor | 9 Village Row, New Hope, PA 18938-1061 | 2007-03-07 |
| 1114064466 | Kyle Hagel | Chiropractor | 9446 36th Ave N, New Hope, MN 55427-1718 | 2007-01-30 |
| Find all providers in NEW HOPE | ||||
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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.