MR. DENNIS LEO ANCO (NPI# 1013568229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013568229 |
| Entity Type | Individual |
| Full Name | MR. DENNIS LEO ANCO |
| Credential | CPO, LPO |
| Practice Address |
1854 Evergreen Draw Woodbury MN 55125-2306 |
| Practice Telephone | 7632285697 |
| Mailing Telephone | 7632285697 |
| Enumeration Date | 2019-09-28 |
| Last Update Date | 2019-09-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | 1089 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 224P00000X | Prosthetist | 1089 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS, AND | CPO04135 | 01 | |
| MN | BOARD OF PODIATRIC MEDICINE | 1089 | 01 |
| Street Address |
1854 EVERGREEN DRAW |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720318876 | Richard Clark Niessen Sr. | Prosthetist | 2025 East River Park Way, Shriners Hospitals for Children Twin Cities, Mpls, MN 55414-3604 | 2010-01-12 |
| 1386900272 | Kyle Robert Hamre | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2012-04-05 |
| 1043538531 | Jill Prinsen | Prosthetist | 360 Sherman St, Suite 299, Saint Paul, MN 55102-2564 | 2010-05-10 |
| 1558691600 | Rebecca Lynn Born | Prosthetist | 2025 East River Parkway, Minneapolis, MN 55414-3604 | 2010-01-12 |
| 1699908483 | Steven Jahn | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2009-08-27 |
| 1760637052 | Sarah Mahowald | Prosthetist | 1 Veterans Dr, Prosthetic Dept. (121), Minneapolis, MN 55417-2309 | 2008-12-01 |
| 1063629368 | Peter Stasica | Prosthetist | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-17 |
| 1902013402 | Joseph Andrew Medvec | Prosthetist | 1 Veterans Dr, Prosthetics 121, Minneapolis, MN 55417-2309 | 2007-05-16 |
| 1013017813 | Chris Peter Boosalis | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2006-09-22 |
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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.