DULUTH KIDNEY SERVICES LLC (NPI# 1972552156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972552156 |
| Entity Type | Organization |
| Organization Name | DULUTH KIDNEY SERVICES LLC |
| Practice Address |
925 E Superior St Suite 106 Duluth MN 55802 |
| Practice Telephone | 2182496230 |
| Practice Fax Number | 2182496231 |
| Mailing Telephone | 2182496230 |
| Mailing Fax Number | 2182496231 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2008-11-11 |
| Authorized Official Name | DR. SANDY POPHAM (OWNER MD) |
| Authorized Official Telephone | 2182496230 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 462137900 | 05 | |
| MEDICA | 9831014 | 01 | |
| MN | BLUE CROSS MN | 04N86PO | 01 |
| Street Address |
925 E SUPERIOR ST SUITE 106 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336126317 | Fredrick E Ekberg | Radiology | 925 E Superior St, Suite 109, Duluth, MN 55802-2238 | 2005-12-29 |
| 1659600435 | Christopher Mark Reilly | Radiology | 925 E Superior St, Ste 109, Duluth, MN 55802-2238 | 2009-12-08 |
| 1023297017 | Rebecca Lynn Kuntz | Radiology | 925 E Superior St, Suite 109, Duluth, MN 55802-2238 | 2007-10-26 |
| 1629287792 | Home Dialysis Duluth Kidney Services | Internal Medicine | 925 E Superior St, Suite 106, Duluth, MN 55802-2238 | 2007-05-22 |
| 1962610923 | Novacare Outpatient Rehabilitation East Inc | Durable Medical Equipment & Medical Supplies | 925 E Superior St, Suite 107, Duluth, MN 55802-2238 | 2007-05-21 |
| 1881733061 | James T Jarosz | Dentist | 925 E Superior St, Suite 101, Duluth, MN 55802-2238 | 2007-02-05 |
| 1295880045 | Kathrynne Marie Dryke | Dentist | 925 E Superior St, 101, Duluth, MN 55802-2238 | 2007-01-24 |
| 1932256948 | Mary S Nett | Radiology | 925 E Superior St, Suite 109, Duluth, MN 55802-2238 | 2007-01-04 |
| 1174670186 | William E. Johnson | Radiology | 925 E Superior St, Suite109, Duluth, MN 55802-2238 | 2007-01-04 |
| 1912932922 | Calvin Cardin Loken | Specialist | 925 E Superior St, Duluth, MN 55802-2238 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992327415 | Julie Baker | Specialist | 907 W Central Entrance, Duluth, MN 55811-5469 | 2020-05-07 |
| 1942510904 | Amanda Rose Kerola | Specialist | 2814 Minnesota Ave, Duluth, MN 55802-2526 | 2010-10-08 |
| 1639323827 | Elegant Touch Massage Therapy | Specialist | 2590 Peachtree Industrial Blvd Ste D, Duluth, GA 30097-3405 | 2008-11-14 |
| 1003089418 | Gwinnett Multi Specialty Group LLC | Specialist | 3840 Peachtree Industrial Boulevard, Duluth, GA 30096-4847 | 2008-04-07 |
| 1790954279 | Generations Health Care Initiative Inc | Specialist | 5 N 3rd Ave W, Suite 310, Duluth, MN 55802 | 2008-02-28 |
| 1912067877 | Barbara Joy Bergstrom | Specialist | 4505 W Superior St, Duluth, MN 55807-2728 | 2006-12-11 |
| 1851474506 | Heide's Mastectomy Services of Duluth. | Specialist | 701 1/2 North 6th Ave. East, Duluth, MN 55805-1333 | 2006-10-23 |
| 1447342241 | Advanced Prosthetics Inc | Specialist | 3540 Duluth Park Lane, Suite 230, Duluth, GA 30096 | 2006-09-29 |
| 1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
| 1932125820 | Northland Urology Asso. P.a. | Specialist | 1000 E 1st St Ste 306, Duluth, MN 55805-2297 | 2006-07-14 |
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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.