DR. JESSE BARONDEAU (NPI# 1760683585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760683585 |
| Entity Type | Individual |
| Full Name | DR. JESSE BARONDEAU |
| Credential | MD |
| Practice Address |
1900 Grassland Dr Mitchell SD 57301-6205 |
| Practice Telephone | 6059957000 |
| Mailing Telephone | 6059957000 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 24022 | NE | Allopathic & Osteopathic Physicians |
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
SD9881 | SD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9040 Jackson Ave, Tacoma, WA 984310001 | 2539681980 |
| Street Address |
1900 GRASSLAND DR |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-6205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306943576 | Xenofon Papadopoulos | Urology | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2006-09-20 |
| 1952911877 | Nancy Jo Miller | Dietitian, Registered | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2020-08-05 |
| 1669027678 | Rural Health Care, Inc | Family Medicine | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-08-06 |
| 1033762984 | Theresa Miiller | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-07-19 |
| 1649831637 | Maggie Riggs | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2019-06-21 |
| 1154896801 | Angela Mae Broughton | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2018-10-09 |
| 1417495649 | Laura Axsom | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2017-02-08 |
| 1881049484 | Avera Queen of Peace | Dermatology | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2016-05-02 |
| 1710359252 | Avera Queen of Peace | Pharmacy | 1900 Grassland Dr, Ste 101, Mitchell, SD 57301 | 2015-10-23 |
| 1780055780 | Lacey Bonte | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2015-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487621579 | S Patrick Weber | Pediatrics | Phs Hospital East Highway 18, Pine Ridge, SD 57770 | 2006-03-07 |
| 1689874745 | David W Mueller | Pediatrics | 2905 5th St, Rapid City, SD 57701-7316 | 2007-07-18 |
| 1770555245 | Patricia J Bunger | Pediatrics | 1001 E 21st St, Ste. 200, Sioux Falls, SD 57105-1033 | 2006-02-07 |
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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.