KEVIN DALE SWENSON (NPI# 1821403635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821403635 |
| Entity Type | Individual |
| Full Name | KEVIN DALE SWENSON |
| Practice Address |
1000 Coney St W Perham MN 56573-2102 |
| Mailing Address |
201 Fox Run Perham MN 56573-2403 |
| Practice Telephone | 2183474500 |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2102 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033270798 | Kevin Shawn Swenson | Dentist | 552 N Main St, Emporia, VA 23847-1236 | 2006-12-13 |
| Street Address |
1000 CONEY ST W |
| City | PERHAM |
| State | MN |
| Zip Code | 56573-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982913505 | Illene T Reed | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2006-05-05 |
| 1174001648 | Jodie Trites | Pharmacist | 1000 Coney St W, Perham, MN 56573-2102 | 2018-08-06 |
| 1649774670 | Colleen Ann Bauck | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2018-03-23 |
| 1770090094 | Amanda Carol Houghtaling | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2018-01-08 |
| 1467971572 | Rose Marie Mader | Registered Nurse | 1000 Coney St W, Perham, MN 56573-2102 | 2017-09-11 |
| 1134656994 | Matthew David Haugen | Family Medicine | 1000 Coney St W, Perham, MN 56573-2102 | 2017-05-11 |
| 1720521818 | Shannon Marie Guck | Physician Assistant | 1000 Coney St W, Perham, MN 56573-2102 | 2016-11-22 |
| 1962854646 | Rayna Bergseth | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2016-07-06 |
| 1972918472 | Melinda Kay Anderson | Nurse Practitioner | 1000 Coney St W, Perham, MN 56573-2102 | 2014-06-24 |
| 1528485877 | Perham Hospital District | Non-Pharmacy Dispensing Site | 1000 Coney St W, Perham, MN 56573-2102 | 2014-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558630012 | Perham Hospital District | Durable Medical Equipment & Medical Supplies | 1000 Coney Street West, Perham, MN 56573 | 2011-12-29 |
| 1730239385 | Dr. Kelvin K. Salathe, P.C. | Chiropractor | 101 West Coney St, Perham, MN 56573 | 2007-01-12 |
| 1124106299 | Langen Family Chiropractic, P.a. | Chiropractor | 108 Market Dr., Perham, MN 56573 | 2006-11-02 |
| 1285710335 | James Odin Langen | Chiropractor | 108 Market Drive, Perham, MN 56573 | 2006-10-31 |
| 1578572202 | Michael L Hamann | Dentist | 200 1st Ave S, Perham, MN 56573 | 2006-08-05 |
| 1033133517 | Timothy Charles Neitzke | Optometrist | 340 Fox St, Perham, MN 56573 | 2006-07-27 |
| 1023063757 | Shopko Stores Operating Co LLC | Pharmacy | 300 Jake St, Perham, MN 56573 | 2006-05-23 |
| 1164917233 | Katlin Larson | Behavior Technician | 735 3rd St Sw, Perham, MN 56573 | 2018-06-29 |
| 1104029347 | Tammy L Sturdevant | Dentist | 335 4th Ave, Perham, MN 56573 | 2007-06-06 |
| 1861610131 | Minnesota Eyecare Network Inc. | Eyewear Supplier (Equipment, not the service) | 340 Fox Street, Perham, MN 56573 | 2007-04-23 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265470447 | Judy A Bellanger-dahl | Physician Assistant | 665 3rd St Sw, Perham, MN 56573-1108 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
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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.