DEREK GOERKE (NPI# 1831519636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831519636 |
| Entity Type | Individual |
| Full Name | DEREK GOERKE |
| Credential | M.D. |
| Practice Address |
11850 Blackfoot St Nw Ste 300 Coon Rapids MN 55433-2772 |
| Mailing Address |
2925 Chicago Ave Minneapolis MN 55407-1321 |
| Practice Telephone | 7632369000 |
| Mailing Telephone | 6122629000 |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2019-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 62180 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
11850 BLACKFOOT ST NW STE 300 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811961675 | David D Brusven | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2006-02-16 |
| 1619452455 | Kati Jo Kaushal | Nurse Practitioner | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2018-09-27 |
| 1023524204 | Chelsie Nicole Horner | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2017-12-24 |
| 1770932626 | Anna M Drewry | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2016-06-10 |
| 1699120972 | Kathleen Ireland | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2016-04-25 |
| 1427489772 | Kaley Ingenito | Physician Assistant | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2013-12-11 |
| 1548580442 | Rachelle N. Damle | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2010-06-03 |
| 1710140389 | Samy Mokhtar Maklad | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2008-07-03 |
| 1548479124 | Nancy Weaver Webster | Obstetrics & Gynecology | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811961675 | David D Brusven | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2006-02-16 |
| 1376856500 | Niloo Shanya Krueger | Surgery | 11850 Blackfoot St Nw, Coon Rapids, MN 55433-2578 | 2010-07-16 |
| 1548580442 | Rachelle N. Damle | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2010-06-03 |
| 1912133752 | Lisa Hamilton | Surgery | 11850 Blackfoot St Nw, Suite 300, Coon Rapids, MN 55433-2578 | 2009-06-08 |
| 1710140389 | Samy Mokhtar Maklad | Surgery | 11850 Blackfoot St Nw Ste 300, Coon Rapids, MN 55433-2772 | 2008-07-03 |
| 1982646451 | David Christopher Kalb | Surgery | 3960 Coon Rapids Blvd Nw, Suite 104, Coon Rapids, MN 55433-2569 | 2006-06-11 |
| 1487617593 | Mark Y Sun | Surgery | 11850 Blackfoot St Nw, Suite 270, Coon Rapids, MN 55433-2578 | 2006-04-10 |
| 1518920628 | Rodney Clyde Lovett | Surgery | 3960 Coon Rapids Blvd Nw, Suite 104, Coon Rapids, MN 55433-2569 | 2006-04-10 |
| 1285696567 | Alan Stuart Johnson | Surgery | 3960 Coon Rapids Blvd Nw, Suite 104, Coon Rapids, MN 55433-2569 | 2006-04-04 |
| 1417917204 | Kevin M Steadland | Surgery | 3960 Coon Rapids Blvd Nw, Suite 104, Coon Rapids, MN 55433-2569 | 2006-03-24 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.