DR. MARK R GUNDERSEN (NPI# 1952390106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952390106 |
| Entity Type | Individual |
| Full Name | DR. MARK R GUNDERSEN |
| Credential | MD |
| Practice Address |
712 South Cascade Street Fergus Falls MN 56537-2813 |
| Mailing Address |
1216 Ryans Rd Worthington MN 56187-1722 |
| Practice Telephone | 2187368000 |
| Practice Fax Number | 2187396742 |
| Mailing Telephone | 5073722921 |
| Mailing Fax Number | 5073726523 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35677 | MN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 4301069187 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4540600 | 05 | |
| MI | MCARE | C4258 | 01 |
| MI | HEALTH NET FEDERAL | F31478 | 01 |
| MI | HEALTH PLUS | 010G56026 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 0802502771 | 01 |
| MI | MCLAREN HEALTH PLAN | 204375 | 01 |
| MI | HEALTH ALLIANCE PLAN | F31478 | 01 |
| MI | METRAHEALTH | 080093188 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 080D410020 | 01 |
| MI | CIGNA | 7073962004 | 01 |
| MI | BLUE CARE NETWORK | 080D410020 | 01 |
| MI | HEALTH ADVANTAGE NETWORK | 204375 | 01 |
| MI | AETNA | 5659321 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154745800 | Mark Gundersen | Case Manager/Care Coordinator | 105 S 3rd St, Saint Helens, OR 97051-2009 | 2014-02-14 |
| Street Address |
712 SOUTH CASCADE STREET |
| City | FERGUS FALLS |
| State | MN |
| Zip Code | 56537-2813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447259973 | Jeffrey A Horak | Surgery | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2005-07-18 |
| 1083847685 | Heidi A Ottenbacher | Optometrist | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2009-08-29 |
| 1003004318 | Gwen P Nordahl | Physician Assistant | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2007-10-11 |
| 1437231750 | Michael J Vanvalkenburg | Emergency Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-10-19 |
| 1033205638 | Jerilyn J. Mitchell | Clinical Nurse Specialist | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-10-04 |
| 1992898936 | Janice Helena Needham Spies | Dietitian, Registered | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-10-02 |
| 1659464683 | Paul Sanderson | Audiologist | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-10-02 |
| 1588765853 | Edward A Williams | Orthopaedic Surgery | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-26 |
| 1437250800 | Robert A Vennerstrom | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-26 |
| 1902906225 | Gregory M. Smith | Pathology | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1336771591 | Paul George Wawin | Psychiatry & Neurology | 712 Cascade St. S. Lake Region Healthcare, Fergus Falls, MN 56537 | 2020-02-06 |
| 1134604127 | Christopher Michael Kjolhaug | Physical Therapist | 1131 South Mabelle Ave, Fergus Falls, MN 56537 | 2018-09-26 |
| 1619406808 | Aaron John Teigen | Physical Therapist | 1304 Lincoln Ave W, Suite C, Fergus Falls, MN 56537 | 2017-06-09 |
| 1003272154 | Anthony Gettel Dc LLC | Chiropractor | 755 Wildwood Trail, Fergus Falls, MN 56537 | 2016-01-05 |
| 1447628912 | Kelsey Shea | Student in an Organized Health Care Education/Training Program | 20743 Red Oak Dr., Fergus Falls, MN 56537 | 2015-09-14 |
| 1881070217 | Vineet Ganapati | Dentist | 2001 W Lincoln Ave # 33, Fergus Falls, MN 56537 | 2015-08-07 |
| 1497004832 | Beverly Renae Reiff | Registered Nurse | 22279 River Oaks Drive, Fergus Falls, MN 56537 | 2012-08-30 |
| 1114221421 | Jane Mary Bjornson | Social Worker | 21081 County Hwy 1, Fergus Falls, MN 56537 | 2010-12-29 |
| Find all providers in zip 56537 | ||||
| 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 |
|---|---|---|---|---|
| 1578100806 | Matthew Ecker | Family Medicine | 2311 W Lincoln Ave, Fergus Falls, MN 56537-1064 | 2019-12-05 |
| 1891087573 | Mark T Vukonich | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537 | 2011-05-12 |
| 1790844009 | Gregory James Peterson | Family Medicine | 1505 Pebble Lake Rd, Suite 500, Fergus Falls, MN 56537-3800 | 2006-12-06 |
| 1437250800 | Robert A Vennerstrom | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-26 |
| 1801996715 | David J Sanderson Jr. | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-22 |
| 1356449227 | Patricia J. Lindholm | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-09-21 |
| 1831201979 | John Martin Thomas | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2006-08-31 |
| 1215044334 | Daniel L Lembcke | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-08-24 |
| 1841210259 | Wesley A Borowski | Family Medicine | 712 South Cascade Street, Fergus Falls, MN 56537-2813 | 2006-07-20 |
| 1134152879 | Christine Lynn Cabrera | Family Medicine | 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2006-07-08 |
| Find all providers in FERGUS FALLS | ||||
| City | FERGUS FALLS |
| Zip Code | 56537 |
Please comment or provide details below to improve the information on DR. MARK R GUNDERSEN.
| 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.