INGRID LOUISA NISSWANDT-LARSEN (NPI# 1548351406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548351406 |
| Entity Type | Individual |
| Full Name | INGRID LOUISA NISSWANDT-LARSEN |
| Credential | MD |
| Practice Address |
4621 E Superior St Duluth MN 55804-2338 |
| Practice Telephone | 2187863550 |
| Mailing Telephone | 2187863550 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2012-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 32323 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 922593500 | 05 |
| Street Address |
4621 E SUPERIOR ST |
| City | DULUTH |
| State | MN |
| Zip Code | 55804-2338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104886977 | Sarah Adeen Ziring | Physical Therapist | 4621 E Superior St, Duluth, MN 55804 | 2006-03-24 |
| 1861031759 | Daniel F Kuevi Akoe | Nurse Practitioner | 4621 E Superior St, Duluth, MN 55804-2338 | 2019-12-26 |
| 1730521717 | Molly C Backstrom | Nurse Practitioner | 4621 E Superior St, Essentia Health Lakeside Clinic, Duluth, MN 55804-2338 | 2013-07-19 |
| 1932276623 | Penny Lynn Bennett | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-11-29 |
| 1043319726 | Molly Herzan Burton | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-09-21 |
| 1831204940 | The Duluth Clinic, Ltd | Pharmacy | 4621 E Superior St, Suite A, Duluth, MN 55804-2338 | 2006-08-20 |
| 1518971118 | Erik J Sather | Family Medicine | 4621 E Superior St, Duluth, MN 55804 | 2006-07-28 |
| 1023034105 | Steven Peter Phillipson | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1962428730 | Angela L. Reichart | Physician Assistant | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1205852076 | Hugh Patrick Renier | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235593591 | Michelle Leblanc | Speech-Language Pathologist | 5017 London Rd., Duluth, MN 55804 | 2016-04-12 |
| 1346541075 | Christina Finlo | Marriage & Family Therapist | 4849 Ivanhoe St, Duluth, MN 55804 | 2010-11-11 |
| 1821301623 | Rachel Gabrielle Ashford | Social Worker | 5107 E Superior St, Duluth, MN 55804 | 2010-07-21 |
| 1932381423 | Janet Florence Lewis | Registered Nurse | 4231 Dodge Street, Duluth, MN 55804 | 2007-11-27 |
| 1245419894 | Ernest Carl Hansen | Physical Therapist | 4002 London Rd., Duluth, MN 55804 | 2007-10-31 |
| 1316011596 | Melissa J. Janzen | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2006-11-20 |
| 1861406522 | Susan Klee Anderson | Family Medicine | 4621 E Superior St., Duluth, MN 55804 | 2006-07-28 |
| 1285831040 | Janzen Chiropractic Pa | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2007-06-27 |
| 1912121708 | Cooley Chiropractic Clinic, Inc. | Chiropractor | 5722 Homestead Rd, Duluth, MN 55804 | 2007-04-12 |
| 1831663343 | Jennifer T Rennquist | Counselor | 5223 Glendale St, Duluth, MN 55804-1110 | 2019-01-17 |
| Find all providers in zip 55804 | ||||
| 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 |
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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.