MATTHEW GRANT PENNING (NPI# 1427285543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427285543 |
| Entity Type | Individual |
| Full Name | MATTHEW GRANT PENNING |
| Credential | M.D. |
| Practice Address |
4190 Loberg Ave Duluth MN 55811-2652 |
| Practice Telephone | 2182495700 |
| Practice Fax Number | 2182494666 |
| Mailing Telephone | 2182495700 |
| Mailing Fax Number | 2182494666 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2018-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 53138 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1427285543 | 05 |
| Street Address |
4190 LOBERG AVE |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-2652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164428280 | Benjamin H Johnson | Family Medicine | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2005-06-23 |
| 1942671201 | Kaitlyn Proulx | Physician Assistant | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2015-10-13 |
| 1417327891 | Edward Hansmeier | Physician Assistant | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2015-09-29 |
| 1619301975 | Kimberly Benning | Nurse Practitioner | 4190 Loberg Ave, Duluth, MN 55811 | 2013-08-22 |
| 1396036893 | Matthew Morris Hansmeier | Family Medicine | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2011-05-02 |
| 1356540827 | Charles Earl Ahrens | Ophthalmology | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2007-07-16 |
| 1124058847 | Gerard David Spoelhof | Family Medicine | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2006-07-05 |
| 1184653065 | Daniel Bruce Campbell | Emergency Medicine | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2006-07-02 |
| 1891748000 | Richard Lee Fraser | Nurse Practitioner | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2006-05-18 |
| 1609828029 | St. Luke's Hospital of Duluth | Family Medicine | 4190 Loberg Ave, Duluth, MN 55811-2652 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| 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 |
|---|---|---|---|---|
| 1811553084 | Clement Ayanbadejo LLC | Family Medicine | 2282 Meadow Church Rd Ste 200, Duluth, GA 30097-5318 | 2019-05-14 |
| 1902391923 | Young-tae Kim | Family Medicine | 3610 Peachtree Industrial Blvd Ste 100, Duluth, GA 30096-5139 | 2018-06-22 |
| 1659655538 | Primary Care of Atlanta | Family Medicine | 4124 Chattahoochee Trce, Ste 103, Duluth, GA 30097-2147 | 2011-10-10 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1497087126 | St. Luke's Hospital of Duluth | Family Medicine | 6351 E. Superior St., Duluth, MN 55804-2545 | 2010-02-05 |
| 1861729816 | Mark Steven Grimsley | Family Medicine | 1611 Satellite Blvd Ste 3, Duluth, GA 30097 | 2009-11-12 |
| 1154552990 | Clement O Ayanbadejo | Family Medicine | 2282 Meadow Church Rd, Ste 200, Duluth, GA 30097-5318 | 2009-07-28 |
| 1891950457 | Liem Chi Ngo | Family Medicine | 4470 Satellite Blvd, Suite 204, Duluth, GA 30096-8851 | 2008-07-23 |
| 1962663302 | Martin Charles Hinz | Family Medicine | 1150 88th Ave W, Duluth, MN 55808-1505 | 2008-06-18 |
| 1447422506 | Onelio Emilio Perdomo | Family Medicine | 3750 Venture Drive, Suite 130, Duluth, GA 30096-1808 | 2008-03-28 |
| Find all providers in DULUTH | ||||
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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.