GREG C RANDALL (NPI# 1255333662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255333662 |
| Entity Type | Individual |
| Full Name | GREG C RANDALL |
| Credential | MD |
| Practice Address |
17599 Kenwood Trl Lakeville MN 55044-8330 |
| Mailing Address |
7801 E Bush Lake Rd Ste 300 Bloomington MN 55439-3120 |
| Practice Telephone | 9529858600 |
| Practice Fax Number | 9529858699 |
| Mailing Telephone | 9529858911 |
| Mailing Fax Number | 9529858999 |
| Enumeration Date | 2005-08-15 |
| 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 | 28794 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
17599 KENWOOD TRL |
| City | LAKEVILLE |
| State | MN |
| Zip Code | 55044-8330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114239415 | Shamoli Patel | Family Medicine | 17599 Kenwood Trl, Lakeville, MN 55044-8330 | 2010-07-02 |
| 1609868280 | Heather R Krueger | Family Medicine | 17599 Kenwood Trl, Lakeville, MN 55044-8330 | 2005-08-18 |
| 1346232519 | Carlos E Figari | Family Medicine | 17599 Kenwood Trl, Lakeville, MN 55044-8330 | 2005-08-16 |
| 1841292265 | Rodney J Mccutcheon | Family Medicine | 17599 Kenwood Trl, Lakeville, MN 55044-8330 | 2005-08-15 |
| 1417959826 | Thomas A Niebeling | Family Medicine | 17599 Kenwood Trl, Lakeville, MN 55044-8330 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1164922373 | Invigorate Chiropractic, Pa | Chiropractor | 18449 Orchard Trail, Lakeville, MN 55044 | 2018-02-14 |
| 1275046344 | Kevin Schultz | Chiropractor | 18449 Orchard Tr, Lakeville, MN 55044 | 2017-11-13 |
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1275069676 | Alison Marie Weaver | Physical Therapist | 17599 Kenwood Trl Ste 200, Lakeville, MN 55044 | 2017-05-04 |
| 1184177479 | Megan Erickson | Physical Therapist | 21034 Heron Way Ste 102, Lakeville, MN 55044 | 2016-08-03 |
| 1669827523 | Kristine Louise Duhamel | Nurse Practitioner | 18275 Kenrick Avenue, Lakeville, MN 55044 | 2016-04-28 |
| 1003281536 | Heather Leann Wegner | Counselor | 16233 Kenyon Ave, Lakeville, MN 55044 | 2015-12-09 |
| 1982081295 | Dana Bungert | Specialist/Technologist | 11060 Upper 167th St W, Lakeville, MN 55044 | 2015-05-06 |
| 1265834931 | Kayla Schulz | Counselor | 7535 165th St West, Lakeville, MN 55044 | 2014-09-24 |
| Find all providers in zip 55044 | ||||
| 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 |
|---|---|---|---|---|
| 1639340409 | Mark S Mellstrom, Md, Pa | Family Medicine | 20157 Icenic Trl, Lakeville, MN 55044-7708 | 2008-03-19 |
| 1801996905 | Charles G Walker | Family Medicine | 15 Vaughan St, Lakeville, MA 02347-1638 | 2006-09-25 |
| 1013941699 | Keyna Ann Martinez | Family Medicine | 601 N. Michigan Street, Lakeville, IN 46536 | 2006-07-10 |
| 1437187655 | Drew T Emerson | Family Medicine | 3509 Thomas Dr, Suite 4, Lakeville, NY 14480-9758 | 2006-06-28 |
| 1699727545 | Beacon Medical Group, Inc. | Family Medicine | 601 North Michigan Street, Lakeville, IN 46536 | 2006-05-17 |
| 1871551994 | Barry A Bershow | Family Medicine | 10450 185th St W, Suite 300, Lakeville, MN 55044-6686 | 2006-05-01 |
| 1124090493 | Robert James Gagnon | Family Medicine | 5 Precinct St, Lakeville, MA 02347-1427 | 2006-02-02 |
| 1275517351 | Ellyn Therese Stecker | Family Medicine | 601 N. Michigan St., Lakeville, IN 46536 | 2005-12-02 |
| 1700393808 | Southcoast Physicians Group, Inc. | Family Medicine | 12 Main St, Lakeville, MA 02347-1606 | 2018-01-10 |
| 1164874574 | Daniel Hanson | Family Medicine | 18432 Kenrick Ave, Lakeville, MN 55044 | 2016-07-09 |
| Find all providers in LAKEVILLE | ||||
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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.