JESSE MICHAEL ANDERSON (NPI# 1750916763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750916763 |
| Entity Type | Individual |
| Full Name | JESSE MICHAEL ANDERSON |
| Credential | PA-C |
| Practice Address |
35 State Ave Ste 1 Faribault MN 55021-6369 |
| Practice Telephone | 5074973528 |
| Practice Fax Number | 5074973722 |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 13321 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609403112 | Jesse Anderson | Social Worker | 1303c Nicholas St, Easton, PA 18045 | 2020-03-25 |
| 1538661186 | Jesse Anderson | Specialist/Technologist | 102 Iverson St W, Saint Joseph, MN 56374-4650 | 2018-02-28 |
| 1518368836 | Jesse Anderson | Chiropractor | 982 N Taylor St, Green Bay, WI 54303-1202 | 2014-09-05 |
| 1164710349 | Jesse Lee Anderson | Physical Therapist | 30 Lawrence Rd Ste 900, Broomall, PA 19008-3301 | 2011-07-21 |
| 1770583080 | Jesse Anderson IIi | Podiatrist | 2401 Godwin Blvd Ste 1, Suffolk, VA 23434-8178 | 2005-07-28 |
| 1578069340 | Jesse Paul Anderson | Behavioral Analyst | 102 Westlake Dr, West Lake Hills, TX 78746-5394 | 2018-04-02 |
| 1629580436 | Jesse Anderson | Orthopaedic Surgery | 18444 N 25th Ave Ste 210, Phoenix, AZ 85023 | 2017-11-02 |
| 1104378215 | Jesse Ward Anderson | Physician Assistant | 207 Foote Ave, Jamestown, NY 14701-7077 | 2016-10-25 |
| 1720333628 | Jesse Willis Anderson | Registered Nurse | 2789 Ortiz Ave, Fort Myers, FL 33905-7806 | 2012-07-17 |
| 1497835474 | Jesse Anderson | Pharmacy Technician | 1001 N Country Club Rd, Ada, OK 74820-2847 | 2006-10-16 |
| Street Address |
35 STATE AVE STE 1 |
| City | FARIBAULT |
| State | MN |
| Zip Code | 55021-6369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477971174 | Thomas Jay Kaiser | Orthopaedic Surgery | 35 State Ave Ste 1, Faribault, MN 55021-6369 | 2014-03-31 |
| 1851858674 | Maksim Kozak | Physician Assistant | 35 State Ave Ste 1, Faribault, MN 55021 | 2019-02-28 |
| 1972006807 | Allina Health System | Orthopaedic Surgery | 35 State Ave Ste 1, Faribault, MN 55021-6369 | 2018-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
| 1053957357 | M&t Sisters of Serendipity Pllc | Counselor | 212a Centralave, Faribault, MN 55021 | 2019-11-21 |
| 1639720485 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 200 8th Avenue Nw, Faribault, MN 55021 | 2019-09-24 |
| 1235663428 | Tanya Borchert | Social Worker | 100 State Avenue, Faribault, MN 55021 | 2017-04-14 |
| 1235589854 | Bashir Omar I | Interpreter | 2426 Park Ave # 309, Faribault, MN 55021 | 2016-06-14 |
| 1790150381 | Rainbow United Care Transportation LLC | Non-emergency Medical Transport (VAN) | 1738 Patrick Bay, Faribault, MN 55021 | 2015-12-08 |
| 1740625938 | Steven James Klapmeier | Family Medicine | 1101 Linden Lane, Mcfffrb Health Service, Faribault, MN 55021 | 2013-05-02 |
| 1528306040 | Discovery Public School of Faribault | Local Education Agency (LEA) | 126 8th St. Nw, Faribault, MN 55021 | 2013-01-17 |
| 1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
| 1770873937 | Faribault Senior Living LLC | Assisted Living Facility | 843 Faribault Road, Faribault, MN 55021 | 2011-04-08 |
| Find all providers in zip 55021 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851858674 | Maksim Kozak | Physician Assistant | 35 State Ave Ste 1, Faribault, MN 55021 | 2019-02-28 |
| 1760953897 | Matthew Ahlskog | Physician Assistant | 100 State Ave, Faribault, MN 55021-6337 | 2018-12-16 |
| 1932461480 | Jennifer Hart | Physician Assistant | 100 State Ave, Faribault, MN 55021-6337 | 2012-06-11 |
| 1518115658 | Nyahon Chieng Chut | Physician Assistant | 35 State Avenue, Faribault, MN 55021 | 2008-09-03 |
| 1417022690 | Christopher J Church | Physician Assistant | 200 State Ave, Faribault, MN 55021-6339 | 2006-11-22 |
| 1275646978 | Meganne Gourley | Physician Assistant | 100 State Ave, Faribault, MN 55021-6337 | 2006-08-16 |
| 1649233081 | Debra Mary Mcguire Lang | Physician Assistant | 1645 Lyndale Ave N Ste 103, Faribault, MN 55021-2935 | 2006-04-07 |
| 1164400057 | Travis L Roethler | Physician Assistant | 300 State Ave, Faribault, MN 55021-6319 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1043811870 | Leiah Hoffman | Physician Assistant | 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 | 2020-11-06 |
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1780284844 | Lily Ganz | Physician Assistant | 2737 Huntington Ave, St Louis Park, MN 55416-3917 | 2020-10-28 |
| 1972103000 | Jaclyn Ann Bautch | Physician Assistant | 24721 State Highway 15, Saint Augusta, MN 56301-9211 | 2020-10-28 |
| 1801496047 | Tanner Vaughn Kramp | Physician Assistant | 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 | 2020-10-27 |
| 1497354955 | Sarah Marti | Physician Assistant | 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 | 2020-10-25 |
| 1598364473 | Kylee N Persing | Physician Assistant | 10 4th Ave S, Saint Cloud, MN 56301-3614 | 2020-10-21 |
| 1073112009 | Reece Edward Mcevoy | Physician Assistant | 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 | 2020-10-21 |
| 1679189021 | Anne Elizabeth Drabot | Physician Assistant | 4741 Vincent Ave S, Minneapolis, MN 55410-1843 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
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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.