MANKATO CLINIC LTD (NPI# 1952576126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952576126 |
| Entity Type | Organization |
| Organization Name | MANKATO CLINIC LTD |
| Other Organization Name | MANKATO CLINIC - DANIELS HEALTH CENTER |
| Practice Address |
1901 Old Minnesota Ave Saint Peter MN 56082-1763 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 5079342325 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2012-10-22 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 34593 | MN | Suppliers |
| Other Name | Type Code |
|---|---|
| Mankato Clinic - Daniels Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104057926 | Mankato Clinic Ltd | Family Medicine | 305 Main St E, Mapleton, MN 56065-2060 | 2009-07-28 |
| Street Address |
1901 OLD MINNESOTA AVE |
| City | SAINT PETER |
| State | MN |
| Zip Code | 56082-1763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134107147 | Lon T Knudson | Pediatrics | 1901 Old Minnesota Ave, Mankato Clinic @ Daniels Health Center, Saint Peter, MN 56082-1763 | 2006-01-09 |
| 1104207174 | Kendra Lee Finn | Family Medicine | 1901 Old Minnesota Ave, Saint Peter, MN 56082-1763 | 2015-06-15 |
| 1013149079 | Jeffrey Thomas Weideman | Physician Assistant | 1901 Old Minnesota Ave, Saint Peter, MN 56082-1763 | 2009-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295276079 | Ashley Jaspers | Nurse Practitioner | 1900 N. Sunrise Drive, Suite #200, St. Peter, MN 56082 | 2017-03-14 |
| 1841730876 | Go Therapy Inc | Speech-Language Pathologist | 830 Sunrise Dr Ste B, Saint Peter, MN 56082 | 2017-02-23 |
| 1487063210 | Ashley Krug | Specialist/Technologist | 800 West College Ave, Saint Peter, MN 56082 | 2014-08-06 |
| 1235578519 | Mikkel Dean Haugen | Dentist | 402 Sunrise Drive, St Peter, MN 56082 | 2013-06-19 |
| 1104163849 | House of Hope, Inc. | Community/Behavioral Health | 201 West Park Row, Suite B, Saint Peter, MN 56082 | 2013-01-15 |
| 1851579700 | Laura J. Hulsebus | Chiropractor | 206 West Walnut St, St Peter, MN 56082 | 2008-02-02 |
| 1588857072 | Michael Joseph Lange | Psychologist | 1703 Csah 15, St. Peter, MN 56082 | 2007-08-20 |
| 1235290420 | Andrew D. Lundquist | Podiatrist | 1901 Oid Minnesota Ave, Mankato Clinic @ Daniel's Health Center, St. Peter, MN 56082 | 2006-12-12 |
| 1962517037 | Mary A Snyder | Dentist | 202 W Walnut, St Peter, MN 56082 | 2006-08-20 |
| 1124041504 | Diane Ruth Bruder | Nurse Practitioner | 2000 Klein Street, St. Peter, MN 56082 | 2006-07-25 |
| Find all providers in zip 56082 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PETER |
| Zip Code | 56082 |
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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.