JEFFREY J HERICKHOFF (NPI# 1245292424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245292424 |
| Entity Type | Individual |
| Full Name | JEFFREY J HERICKHOFF |
| Credential | MD |
| Practice Address |
1690 University Ave W Suite 460 Saint Paul MN 55104-3723 |
| Practice Telephone | 6512322002 |
| Practice Fax Number | 6512322031 |
| Mailing Telephone | 6512322002 |
| Mailing Fax Number | 6512322031 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35889 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
1690 UNIVERSITY AVE W SUITE 460 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790783652 | William Emmett Walsh | Allergy & Immunology | 1690 University Ave W, Suite 450, Saint Paul, MN 55104-3723 | 2005-07-13 |
| 1417215880 | Lisa K Hellem | Dietitian, Registered | 1690 University Ave W, Ste 370, Saint Paul, MN 55104-3723 | 2012-04-24 |
| 1336310283 | Healtheast Care System | Non-Pharmacy Dispensing Site | 1690 University Ave W, Suite 570, Saint Paul, MN 55104-3723 | 2008-03-19 |
| 1437355278 | Maja Visekruna | Internal Medicine | 1690 University Ave W, Saint Paul, MN 55104-3723 | 2007-06-26 |
| 1992895304 | Tammy Anne Chiesa | Internal Medicine | 1690 University Ave W, 570, Saint Paul, MN 55104-3723 | 2006-10-14 |
| 1952413692 | Lee A Toman | Internal Medicine | 1690 University Ave W, Ste. 570, Saint Paul, MN 55104-3723 | 2006-08-31 |
| 1730297987 | Joseph Paul Amberg | Internal Medicine | 1690 University Ave W, Ste 570, Saint Paul, MN 55104-3741 | 2006-08-28 |
| 1609984038 | Samantha J Brown | Internal Medicine | 1690 University Ave W, Suite 570, Saint Paul, MN 55104-3723 | 2006-08-27 |
| 1356457287 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 1690 University Ave W, #b-100, Saint Paul, MN 55104-3117 | 2006-08-22 |
| 1154341618 | Adult and Child Allergy, P.a. | Allergy & Immunology | 1690 University Ave W, Suite 450, Saint Paul, MN 55104-3723 | 2006-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457889420 | Thanh Phung | Family Medicine | 2155 Ford Pkwy Ste A, Saint Paul, MN 55116-2799 | 2017-06-02 |
| 1518338268 | Northstar Professional Services | Family Medicine | 924 Rice St, Saint Paul, MN 55117-4987 | 2015-10-07 |
| 1386064111 | Laura Giegler | Family Medicine | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 | 2014-04-19 |
| 1306287719 | John Gordon Faughnan | Family Medicine | 1660 Stanford Ave, Saint Paul, MN 55105-2038 | 2013-07-13 |
| 1194041277 | Mark William Eaton | Family Medicine | 333 Smith Ave N # Ms 60202, Saint Paul, MN 55102-2344 | 2010-04-14 |
| 1326277815 | Branden James Pfefferkorn | Family Medicine | 2004 Ford Pkwy # Ms 35300a, Saint Paul, MN 55116-1931 | 2009-07-07 |
| 1780812651 | James Edward Hougas IIi | Family Medicine | Ump Phalen Village Clinic, 1414 Maryland Ave E, Saint Paul, MN 55106 | 2009-06-30 |
| 1871748509 | Deborah Lee Wexler | Family Medicine | 1573 Selby Ave, Suite 234, Saint Paul, MN 55104-6293 | 2008-11-21 |
| 1124206677 | Family Healthservices Minnesota, P.a. | Family Medicine | 2025 Sloan Pl, Suite 35, Saint Paul, MN 55117-2007 | 2008-02-07 |
| 1174703805 | Family Healthservices Minnesota, P.a. Dba Entira Family Clinics | Family Medicine | 1385 Phalen Boulevard, Saint Paul, MN 55106 | 2007-11-09 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
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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.