PETER KOONTZ (NPI# 1831165539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831165539 |
| Entity Type | Individual |
| Full Name | PETER KOONTZ |
| Credential | MD |
| Practice Address |
3809 42nd Ave S Minneapolis MN 55406-3503 |
| Practice Telephone | 6127216261 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2008-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 16269 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
3809 42ND AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-3503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972579670 | Angela Dhruvan | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2006-02-23 |
| 1124438734 | Marissa Drake | Registered Nurse | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2014-05-05 |
| 1689010357 | Jodi Lynn Johnson | Registered Nurse | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2013-05-21 |
| 1780942078 | Deqa Yassin Mohamed | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406 | 2012-04-25 |
| 1093005498 | Gennadiy Vasilyevich Shevchenko | Psychiatry & Neurology | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2011-04-19 |
| 1538492103 | Jennifer Lynn Nickell | Pharmacist | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2009-09-14 |
| 1598921108 | Katharine Jones Plosser | Physician Assistant | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-08-03 |
| 1922271857 | Sandeep Kalola | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2008-04-11 |
| 1346432218 | Fairview Clinics | Clinic/Center | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-08-15 |
| 1932328226 | Louisa Paul | Family Medicine | 3809 42nd Ave S, Minneapolis, MN 55406-3503 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| 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 |
|---|---|---|---|---|
| 1336594498 | Jaimi Weber | Family Medicine | Mmc 381, 420 Delaware St. Se, Minneapolis, MN 55445 | 2016-04-26 |
| 1376906388 | Sama Healthcare | Family Medicine | 2639 Nicollet Ave., Suite 130, Minneapolis, MN 55408 | 2016-03-29 |
| 1902209687 | Elaine May | Family Medicine | 2861 Burnham Blvd, Minneapolis, MN 55416-4331 | 2014-10-08 |
| 1952741050 | Gregory Olszewski | Family Medicine | 19 S 1st St Apt B2603, Minneapolis, MN 55401-1845 | 2013-07-03 |
| 1881940864 | Isaac Milton Engholm | Family Medicine | 825 Nicollet Mall Ste 403, Minneapolis, MN 55402-2611 | 2012-07-27 |
| 1942572763 | Neighborhood Healthsource | Family Medicine | 1015 4th Avenue North, Suite 201, Minneapolis, MN 55405-1178 | 2012-02-09 |
| 1225323371 | Yun Chau Bernice Lee | Family Medicine | 2823 Dean Pkwy, Minneapolis, MN 55416-4401 | 2011-06-16 |
| 1730487208 | Specialized Medical Response, LLC | Family Medicine | 401 Harding St Ne #100, Minneapolis, MN 55413 | 2011-03-08 |
| 1285930065 | Allina Health System | Family Medicine | 3024 Snelling Ave S, Minneapolis, MN 55406-1911 | 2011-01-27 |
| 1013226844 | Corban Health Care, Pllc | Family Medicine | 5141 36th Ave S, Minneapolis, MN 55417-1518 | 2010-09-28 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
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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.