MR. JACOB GREGORY GUTH (NPI# 1134169774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134169774 |
| Entity Type | Individual |
| Full Name | MR. JACOB GREGORY GUTH |
| Credential | P.A.C |
| Practice Address |
1835 County Road C West Suite 150 Stillwater MN 55082-5078 |
| Mailing Address |
1950 Northwestern Ave S Ste 102 Stillwater MN 55082-7615 |
| Practice Telephone | 6512594501 |
| Practice Fax Number | 6514301447 |
| Mailing Telephone | 6514303800 |
| Mailing Fax Number | 6514303827 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 393 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | AMERICAS PPO | 2443375 | 01 |
| MN | PREFERRED ONE | 1047498 | 01 |
| MN | UCARE | 135584 | 01 |
| MN | HEALTH PARTNERS | HP65749 | 01 |
| MN | BLUE CROSS & BLUE SHIELD | 527G9GU | 01 |
| MN | MEDICA | 0124329 | 01 |
| MN | 747410500 | 05 | |
| WI | 42886700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7373 France Ave S Ste 408, Edina, MN 554354549 | 6514303800 | 6514303827 |
| Street Address |
1835 COUNTY ROAD C WEST SUITE 150 |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082-5078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843782 | Andrea Claire Mueller | Physician Assistant | 8050 Imperial Ct N, Stillwater, MN 55082-9340 | 2020-02-21 |
| 1235604984 | Zachary T Edens | Physician Assistant | 1909 W 6th Ave Ste B, Stillwater, OK 74074-4204 | 2018-10-09 |
| 1881916179 | Meredith Pruitt | Physician Assistant | 1009 W 9th Ave, Stillwater, OK 74074-5404 | 2010-02-27 |
| 1366488587 | Eric Sage Salman | Physician Assistant | 1950 Curve Crest Blvd W, Suite100, Stillwater, MN 55082-5078 | 2006-06-22 |
| 1124012638 | Elizabeth Fell Loken | Physician Assistant | 5701 Stillwater Blvd N, Stillwater, MN 55082-1030 | 2005-09-12 |
| 1174121677 | Christen Nelson | Physician Assistant | 511 Windsor Dr, Stillwater, OK 74074-6962 | 2020-10-16 |
| 1194336412 | Anna Kaci Renner | Physician Assistant | 270 Main St N Ste 300, Stillwater, MN 55082-6788 | 2020-08-11 |
| 1275163735 | Trevor Duade Maxwell | Physician Assistant | 275 S Perkins Rd, Stillwater, OK 74074-3665 | 2020-01-23 |
| 1649821646 | Robert Monroe Poutre | Physician Assistant | 1701 Curve Crest Blvd W Ste 104, Stillwater, MN 55082-6181 | 2019-09-23 |
| 1437610094 | Kyndell Denise Weder | Physician Assistant | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2019-03-27 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 55082 |
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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.