| Northwestern Health Sciences University | |
|
2501 W 84th St Bloomington MN 55431-1602 | |
| (952) 888-4777 | |
| (952) 886-7590 |
| Full Name | Northwestern Health Sciences University |
|---|---|
| Speciality | Clinic/Center |
| Location | 2501 W 84th St, Bloomington, Minnesota |
| Authorized Official Name and Position | John B Wolfe (COMPLIANCE OFFICER) |
| Authorized Official Contact | 9528884777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwestern Health Sciences University 2501 West 84th Street Bloomington MN 55431-1599 Ph: (952) 888-4777 | Northwestern Health Sciences University 2501 W 84th St Bloomington MN 55431-1602 Ph: (952) 888-4777 |
| NPI Number | 1124103544 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 12/27/2021 |
| Medicare PECOS PAC ID | 8820088834 |
|---|---|
| Medicare Enrollment ID | O20040513000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124103544 | NPI | - | NPPES |
| 7261471 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Douglas G Kaster |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1063613305 PECOS PAC ID: 8022057942 Enrollment ID: I20050429000747 |
| Provider Name | Amanda R Gebhardt-fitzgerald |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518069756 PECOS PAC ID: 9638119712 Enrollment ID: I20050509000258 |
| Provider Name | Amy L Horton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740363795 PECOS PAC ID: 8527075290 Enrollment ID: I20060321000695 |
| Provider Name | Stacy M Boone-vikingson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1487682274 PECOS PAC ID: 8022012699 Enrollment ID: I20060913000255 |
| Provider Name | Anne M Packard Spicer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962585927 PECOS PAC ID: 3173656618 Enrollment ID: I20100804000127 |
| Provider Name | Zachary J Zachman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194808162 PECOS PAC ID: 0042343584 Enrollment ID: I20100804000167 |
| Provider Name | Bradley A Finer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093898041 PECOS PAC ID: 6103950100 Enrollment ID: I20100812000558 |
| Provider Name | David J Smith |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326125584 PECOS PAC ID: 2567596398 Enrollment ID: I20100816001099 |
| Provider Name | Melissa E Macdonald |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578012951 PECOS PAC ID: 0244518827 Enrollment ID: I20161102001541 |
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