JOHN G. STARK M.D.P.A. (NPI# 1780863316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780863316 |
| Entity Type | Organization |
| Organization Name | JOHN G. STARK M.D.P.A. |
| Other Organization Name | STARK SPECIALTY ORTHOPAEDICS, STARK CLINIC |
| Practice Address |
825 Nicollet Mall Ste 715 Minneapolis MN 55402-2613 |
| Practice Telephone | 6123322324 |
| Practice Fax Number | 6123321019 |
| Mailing Telephone | 6123322324 |
| Mailing Fax Number | 6123321019 |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2007-10-31 |
| Authorized Official Name | DR. JOHN G STARK (OWNER) |
| Authorized Official Telephone | 6123322324 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
23369 | MN | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Stark Specialty Orthopaedics, Stark Clinic | Doing Business As Name - Organization |
| Street Address |
825 NICOLLET MALL STE 715 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55402-2613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164040457 | Colby Orthodontics LLC | Dentist | 9th St. and Nicollet Ave. Suite 531, Minneapolis, MN 55402 | 2020-07-13 |
| 1124684725 | Eric James Holthaus | Dentist | 825 Nicollet Ave #1025, Minneapolis, MN 55402 | 2019-05-20 |
| 1194216598 | Sean Templeman | Optometrist | 825 Nicollet Mall Fl 20, Minneapolis, MN 55402 | 2018-05-22 |
| 1124529417 | Danielle Marie Kasprzak | Social Worker | 825 Nicollet Mall Ste 1005, Minneapolis, MN 55402 | 2018-02-22 |
| 1275073181 | Yellow Coriander, Psc | Nurse Practitioner | 60 South 6th Street, Suite 2800, Minneapolis, MN 55402 | 2017-02-27 |
| 1780039263 | Ursula Mcguckin | Dentist | 825 Nicollet Avenue #1025, Minneapolis, MN 55402 | 2016-05-03 |
| 1265891600 | Carl Mothes | Counselor | 825 Nicollet Mall Ste 556, Minneapolis, MN 55402 | 2016-02-13 |
| 1295084309 | Cardiology Prevention, LLC | Clinic/Center | 730 Second Ave South, Suite 295, Baker Center, Minneapolis, MN 55402 | 2012-09-05 |
| 1629389341 | Michael Stephen Bevan | Podiatrist | 825 Nicollet Mall Ste 517, Minneapolis, MN 55402 | 2010-06-28 |
| 1235368226 | Anna Dickens | Nurse Practitioner | 902 2nd Ave S, Ste 400, Minneapolis, MN 55402 | 2009-07-10 |
| Find all providers in zip 55402 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629462825 | Daniel Kim | Orthopaedic Surgery | 913 E 26th St, Minneapolis, MN 55404-4515 | 2015-03-25 |
| 1740536481 | Kedar Jayant Deogaonkar | Orthopaedic Surgery | 913 E 26th St, 600, Minneapolis, MN 55404-4515 | 2012-07-31 |
| 1326375353 | Carlos A Castro | Orthopaedic Surgery | 913 E 26th St, Suite 600, Minneapolis, MN 55404-4515 | 2009-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740220466 | Thomas Vincent Rieser | Orthopaedic Surgery | 1950 Curve Crest Blvd W Ste 130, Stillwater, MN 55082-6062 | 2006-06-08 |
| 1598712788 | Glenn Robin Buttermann | Orthopaedic Surgery | 1835 County Road C W Ste 150, Roseville, MN 55113-1343 | 2006-05-31 |
| 1649220849 | Garry M Banks | Orthopaedic Surgery | 8290 University Ave Ne Ste 200, Fridley, MN 55432-1876 | 2006-05-11 |
| 1114989555 | Sunny S Kim | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2006-04-03 |
| 1023001815 | Ilbnc, P.a. | Orthopaedic Surgery | 3001 Metro Dr, Suite 330, Bloomington, MN 55425-4506 | 2005-08-26 |
| 1881690493 | Daniel W Hanson | Orthopaedic Surgery | 2780 Snelling Ave N Ste 310, Roseville, MN 55113-7125 | 2005-06-28 |
| 1336765098 | Inspired Spine Surgcenter LLC | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2020-06-18 |
| 1427686575 | Sunny S. Kim, Md Pa | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2020-04-01 |
| 1205481041 | Sunny S. Kim, Md Pa | Orthopaedic Surgery | 1601 Highway 13 E Ste 211, Burnsville, MN 55337-5105 | 2019-08-08 |
| 1508356619 | Thomas Rieser Md Pllc | Orthopaedic Surgery | 1950 Curve Crest Blvd W Ste 130, Stillwater, MN 55082 | 2018-05-14 |
| Find all providers with the same taxonomy | ||||
| City | MINNEAPOLIS |
| Zip Code | 55402 |
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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.