DR. JOHN GREGORY STARK (NPI# 1306816996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306816996 |
Entity Type | Individual |
Full Name | DR. JOHN GREGORY STARK |
Credential | MD |
Practice Address |
825 Nicollet Mall Suite 715 Minneapolis MN 55402-2595 |
Mailing Address |
825 Nicollet Mall Suite 715 Minneapolis MN 55402-2606 |
Practice Telephone | 6123322324 |
Practice Fax Number | 6123321019 |
Mailing Telephone | 6123322324 |
Mailing Fax Number | 6123321019 |
Enumeration Date | 2006-01-25 |
Last Update Date | 2013-06-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 23369 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | PHP/MEDICA | 09-01240 | 01 |
MN | 126002200 | 05 | |
MN | MINNESOTA MEDICAL LICENSE | 23369 | 01 |
MN | DEA | AS8070877 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982244687 | John Gilbert Stark Jr. | Counselor | 417 Arnold Ct, Kokomo, IN 46902-3702 | 2020-01-10 |
1811082753 | John D Stark | Dentist | 2120 W 12600 S, Riverton, UT 84065-7131 | 2006-10-04 |
1922087618 | John B Stark | Orthopaedic Surgery | One Orthopaedic Place, St. Augustine, FL 32086-4202 | 2006-01-11 |
1659704799 | John Kyle Stark | Dentist | 1 Kneeland St, 8th Floor - Pediatric Dentistry, Boston, MA 02111-1527 | 2013-08-13 |
1962628578 | John Mitchell Stark | Physical Therapy Assistant | 2100 Exeter Rd, Germantown, TN 38138-3922 | 2007-04-18 |
1023176799 | John Daniel Stark | Counselor | 4110 Highway 31 South, Decatur, AL 35603 | 2006-12-05 |
1710927769 | John Stark | Family Medicine | 161 Corporate Dr, Portsmouth, NH 03801-6825 | 2006-06-07 |
Street Address |
825 NICOLLET MALL SUITE 715 |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55402-2595 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093718892 | Dinesh K Goyal | Ophthalmology | 825 Nicollet Mall, Ste 2000, Minneapolis, MN 55402-2708 | 2005-05-24 |
1851836464 | Denise Brown | Nurse Practitioner | 825 Nicollet Mall, Medical Arts Building Suite 300, Minneapolis, MN 55402-2525 | 2017-01-05 |
1881138527 | Stefanie Marie Donnelly | Counselor | 825 Nicollet Mall, Suite 415, Minneapolis, MN 55402-2606 | 2016-12-15 |
1073063103 | Minnesota Dental Professionals, P.C. | Dentist | 825 Nicollet Mall, Ste 425, Minneapolis, MN 55402-2606 | 2016-10-13 |
1326596032 | Michael Studer | Acupuncturist | 825 Nicollet Mall, Suite 923, Minneapolis, MN 55402-2606 | 2016-09-12 |
1104272939 | Donald Clausen Dds Ms Pa | Dentist | 825 Nicollet Mall, Ste 825, Minneapolis, MN 55402-2606 | 2016-05-11 |
1841656410 | Cityscape Dental Pa | Dentist | 825 Nicollet Mall, Suite# 1921, Minneapolis, MN 55402-2606 | 2016-01-12 |
1629442538 | Skin Specialists | Dermatology | 825 Nicollet Mall, Suite 1002, Minneapolis, MN 55402-2614 | 2015-11-17 |
1790171171 | Mill City Dermatology, P.a. | Clinic/Center | 825 Nicollet Mall, Suite 1227, Minneapolis, MN 55402-2606 | 2015-04-12 |
1760894372 | Svetlana Simovic, M.d. | Psychiatry & Neurology | 825 Nicollet Mall, Suite # 614, Minneapolis, MN 55402-2606 | 2014-05-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164040457 | Colby Orthodontics LLC | Dentist | 9th St. and Nicollet Ave. Suite 531, Minneapolis, MN 55402 | 2020-07-13 |
1124684725 | Eric James Holthaus | Dentist | 825 Nicollet Ave #1025, Minneapolis, MN 55402 | 2019-05-20 |
1194216598 | Sean Templeman | Optometrist | 825 Nicollet Mall Fl 20, Minneapolis, MN 55402 | 2018-05-22 |
1124529417 | Danielle Marie Kasprzak | Social Worker | 825 Nicollet Mall Ste 1005, Minneapolis, MN 55402 | 2018-02-22 |
1275073181 | Yellow Coriander, Psc | Nurse Practitioner | 60 South 6th Street, Suite 2800, Minneapolis, MN 55402 | 2017-02-27 |
1780039263 | Ursula Mcguckin | Dentist | 825 Nicollet Avenue #1025, Minneapolis, MN 55402 | 2016-05-03 |
1265891600 | Carl Mothes | Counselor | 825 Nicollet Mall Ste 556, Minneapolis, MN 55402 | 2016-02-13 |
1295084309 | Cardiology Prevention, LLC | Clinic/Center | 730 Second Ave South, Suite 295, Baker Center, Minneapolis, MN 55402 | 2012-09-05 |
1629389341 | Michael Stephen Bevan | Podiatrist | 825 Nicollet Mall Ste 517, Minneapolis, MN 55402 | 2010-06-28 |
1235368226 | Anna Dickens | Nurse Practitioner | 902 2nd Ave S, Ste 400, Minneapolis, MN 55402 | 2009-07-10 |
Find all providers in zip 55402 |
Taxonomy Code | 204C00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neuromusculoskeletal Medicine, Sports Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891841128 | Chiromed Clinic, P.a. | Neuromusculoskeletal Medicine, Sports Medicine | 5355 Penn Ave S, Minneapolis, MN 55419-1056 | 2007-01-27 |
1629193446 | Metropolitan Internists, Pa | Neuromusculoskeletal Medicine, Sports Medicine | 825 S 8th St, Suite #600 Parkside Prof Bldg, Minneapolis, MN 55404-1208 | 2007-03-20 |
1528163581 | James Herbert House | Neuromusculoskeletal Medicine, Sports Medicine | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2006-09-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457963191 | Tressa Dee Weeden-bootz | Neuromusculoskeletal Medicine, Sports Medicine | 8071 Curtis Ln, Eden Prairie, MN 55347-1110 | 2020-08-22 |
1639121460 | James Edmund Call Jr. | Neuromusculoskeletal Medicine, Sports Medicine | 22015 State Highway 6, Deerwood, MN 56444-6278 | 2006-05-17 |
1164410270 | Robert A Morgan | Neuromusculoskeletal Medicine, Sports Medicine | 640 Jackson St - Mc 11503l, Healthpartners Regions Specialty Clinics, St. Paul, MN 55101-2502 | 2005-10-12 |
1679560213 | Matthew A. Raml | Neuromusculoskeletal Medicine, Sports Medicine | 1500 Irving St, Alexandria, MN 56308-2515 | 2005-09-29 |
1184148017 | Andrew Jacob Olson | Neuromusculoskeletal Medicine, Sports Medicine | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2017-08-02 |
1528389244 | Nicolas N Madigan | Neuromusculoskeletal Medicine, Sports Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2010-06-16 |
1275671711 | David Benjamin Ketroser | Neuromusculoskeletal Medicine, Sports Medicine | 2000 Plymouth Rd, Suite 110, Minnetonka, MN 55305-2366 | 2007-02-04 |
1194751552 | Sports and Orthopaedic Specialists, Pa | Neuromusculoskeletal Medicine, Sports Medicine | 8100 W 78th St, Suite 225, Edina, MN 55439-2516 | 2006-06-25 |
1013970144 | James Richard Larson | Neuromusculoskeletal Medicine, Sports Medicine | 8100 W 78th St, Suite 225, Edina, MN 55439-2516 | 2006-04-10 |
1518931799 | Julie A Switzer | Neuromusculoskeletal Medicine, Sports Medicine | 435 Phalen Blvd - Ms 51103h, Healthpartners Specialty Center 435, St. Paul, MN 55130-5302 | 2006-02-15 |
Find all providers with the same taxonomy |
City | MINNEAPOLIS |
Zip Code | 55402 |
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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.