ST. CLOUD EAR, NOSE & THROAT CLINIC, P.A. (NPI# 1508882754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508882754 |
| Entity Type | Organization |
| Organization Name | ST. CLOUD EAR, NOSE & THROAT CLINIC, P.A. |
| Other Organization Name | ST. CLOUD EAR, NOSE & THROAT - HEAD & NECK CLINIC |
| Practice Address |
1528 Northway Dr Saint Cloud MN 56303-1255 |
| Practice Telephone | 3202520233 |
| Mailing Telephone | 3202520233 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-07-06 |
| Authorized Official Name | MS. BRENDA SCHNEIDER (ASSISTANT ADMINISTRATOR) |
| Authorized Official Telephone | 3202571139 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS BLUE SHIELD | 55319CL | 01 |
| MN | 508208100 | 05 |
| Other Name | Type Code |
|---|---|
| St. Cloud Ear, Nose & Throat - Head & Neck Clinic | Other Name - Individual/Organization |
| Street Address |
1528 NORTHWAY DR |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306806807 | Stephen Cragle | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-27 |
| 1639777907 | Casandra Leigh Conlee | Audiologist | 1528 Northway Dr, Saint Cloud, MN 56303-1287 | 2020-10-09 |
| 1912232489 | John Cameron Littlefield | Speech-Language Pathologist | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2009-10-16 |
| 1265663439 | Kari A Krein | Speech-Language Pathologist | 1528 Northway Dr, Saint Cloud, MN 56303-1287 | 2009-08-05 |
| 1417188830 | St. Cloud Ear, Nose & Throat - Surgical Suites LLC | Clinic/Center | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2009-08-03 |
| 1588828206 | Amy Corinne Dearking | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2008-07-11 |
| 1831361195 | Alexandra R Borders | Audiologist | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2008-03-27 |
| 1861617367 | Stacey Lynn Johnson | Audiologist | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2007-04-17 |
| 1902020928 | Sveinar Ydstebo Larsen | Audiologist | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2007-04-12 |
| 1740404854 | Jessica Lynn Landucci | Audiologist | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2007-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306806807 | Stephen Cragle | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-27 |
| 1588828206 | Amy Corinne Dearking | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2008-07-11 |
| 1972564987 | Ronald Hanson | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-29 |
| 1841251873 | Todd Magnuson | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-29 |
| 1679534689 | Gerald Jurgens | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-29 |
| 1740240258 | Theodore Truitt | Otolaryngology | 1528 Northway Dr, Saint Cloud, MN 56303-1255 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1740697689 | Katherine Lees | Otolaryngology | 200 First St Nw, Rochester, MN 55905-0001 | 2014-07-11 |
| 1679810709 | Jane-marie Grace Skorina | Otolaryngology | 3308 Irving Ave S, Minneapolis, MN 55408-3320 | 2013-01-09 |
| 1306165972 | Sobia Khaja | Otolaryngology | 516 Delaware St Se Mmc 396, University of Minnesota - Department of Otolaryngology, Minneapolis, MN 55455 | 2010-05-21 |
| 1629208558 | John Burton Young Jr. | Otolaryngology | 2787 Itasca Ave., St. Mary's Pt., MN 55043-0325 | 2009-07-27 |
| 1063675825 | Daniel Scott Schneider | Otolaryngology | 1021 Bandana Blvd West, Saint Paul, MN 55108-5107 | 2008-07-02 |
| 1275707572 | Joshua Yorgason | Otolaryngology | 3366 Oakdale Ave N Ste 150, Robbinsdale, MN 55422-2961 | 2008-04-17 |
| 1558532135 | Norman Thomas Berlinger | Otolaryngology | 320 Manitoba Ave, Wayzata, MN 55391-1614 | 2008-03-21 |
| 1366629461 | Ridgeview Clinics | Otolaryngology | 223 N Carver St, Winthrop, MN 55396 | 2008-01-31 |
| 1598976326 | Oakdale Ear, Nose & Throat Clinic, P.a. | Otolaryngology | 3366 Oakdale Ave North, Suite 150, Robbinsdale, MN 55422 | 2007-05-24 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.