AMY M BERGLIN (NPI# 1821057910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821057910 |
| Entity Type | Individual |
| Full Name | AMY M BERGLIN |
| Other Name | AMY MARIE DAVIS |
| Credential | PA-C |
| Practice Address |
3833 Coon Rapids Blvd Nw Ste 120 Coon Rapids MN 55433-2599 |
| Mailing Address |
12000 Elm Creek Blvd, Suite 360 Maple Grove MN 55369-7076 |
| Practice Telephone | 7637673350 |
| Practice Fax Number | 7637670912 |
| Mailing Telephone | 7634201010 |
| Mailing Fax Number | 7634203710 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2018-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
9768 | MN | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | 9768 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3833 COON RAPIDS BLVD NW STE 120 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891250163 | Patricia Sandkamp | Marriage & Family Therapist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2019-01-31 |
| 1972075893 | Shu-chun Lee | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2018-12-18 |
| 1083108138 | Kristal Ficzeri | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2018-06-20 |
| 1164961413 | Richard Todd | Psychologist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2017-02-20 |
| 1912456062 | Tara Tait | Physician Assistant | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2016-09-30 |
| 1043670581 | Abigail Fletcher | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2016-02-25 |
| 1679947543 | Jessica Fanberg | Social Worker | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2015-11-16 |
| 1215319504 | Valissa Milanovich | Marriage & Family Therapist | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2015-06-23 |
| 1891199378 | Christina Staebell | Social Worker | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2014-10-13 |
| 1487058020 | Melissa Langewisch | Counselor | 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433-2599 | 2014-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1760083059 | Amanda Hanover | Physician Assistant | 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 | 2020-11-04 |
| 1619442290 | Mh 101 At Cretex | Physician Assistant | 8600 Evergreen Blvd Nw, Coon Rapids, MN 55433-6036 | 2018-10-10 |
| 1528332301 | Cole Jeffrey Weiske | Physician Assistant | 3111 124th Ave Nw Ste 200, Coon Rapids, MN 55433-4573 | 2012-02-27 |
| 1003189507 | Ashlee Ann Taylor | Physician Assistant | 13190 Orchid St Nw, Coon Rapids, MN 55448-1083 | 2012-02-14 |
| 1164737417 | Nicholas James Pruett | Physician Assistant | 11850 Blackfoot St Nw Ste 490, Coon Rapids, MN 55433-2773 | 2010-08-11 |
| 1003094111 | Gretchen Olsen Zachel | Physician Assistant | 1879 128th Ave Nw, Coon Rapids, MN 55448-7003 | 2008-01-31 |
| 1356535926 | Kristine Elizabeth Michael | Physician Assistant | 3833 Coon Rapids Blvd, Suite 100, Coon Rapids, MN 55433-2697 | 2007-08-28 |
| 1578529889 | Christine Kelley | Physician Assistant | 3833 Coon Rapids Blvd Nw, Suite 100, Coon Rapids, MN 55433-2643 | 2006-04-25 |
| 1194797894 | Minuteclinic Diagnostic Pa | Physician Assistant | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2006-02-06 |
| 1851924302 | Jenna Michele Borgstrom | Physician Assistant | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2020-02-12 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.