DR. KEN JULIAN TAKEKOSHI (NPI# 1841349149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841349149 |
| Entity Type | Individual |
| Full Name | DR. KEN JULIAN TAKEKOSHI |
| Credential | M.D. |
| Practice Address |
1766 Trail Rd Mendota Heights MN 55118-3730 |
| Practice Telephone | 6517560038 |
| Practice Fax Number | 6513890175 |
| Mailing Telephone | 6517560038 |
| Mailing Fax Number | 6513890175 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2017-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
036-114264 | IL | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
54291 | MN | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
56407-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
4301076830 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4991871 | 05 | |
| MI | BCBS | 220F160310 | 01 |
| Street Address |
1766 TRAIL RD |
| City | MENDOTA HEIGHTS |
| State | MN |
| Zip Code | 55118-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033764428 | Able Solutions LLC | Day Training, Developmentally Disabled Services | 260 E Wentworth Ave Suite 112, St Paul, MN 55118 | 2019-08-03 |
| 1861059974 | Tanya F Langford | Massage Therapist | 3627 Cedar Ave No., 1166 S Robert St. St. Paul West, St. Paul, MN 55118 | 2019-05-23 |
| 1396210779 | Southview Operations LLC | Skilled Nursing Facility | 2000 Oakdale Avenue, West St. Paul, MN 55118 | 2018-10-11 |
| 1538643424 | Marcus James Rohrbauck | Social Worker | 1312-1314 Livingston Avenue, West St. Paul, MN 55118 | 2018-09-18 |
| 1609394287 | Eric Graham Dorr | Pharmacist | 149 Thompson Ave East, Suite 150, West Saint Paul, MN 55118 | 2017-09-05 |
| 1518485242 | Meaghan Claire Puckett | Marriage & Family Therapist | 33 Wentworth Ave E Ste 210, West St Paul, MN 55118 | 2017-09-01 |
| 1174078307 | Michal Frank | Counselor | 240 Dakota St, West Saint Paul, MN 55118 | 2016-08-17 |
| 1184011868 | Rachel Devries | Pediatrics | 1880 Livingston Ave Ste 102, West St Paul, MN 55118 | 2015-04-21 |
| 1124411772 | Ahmed Salad Associates | Dentist | 1200 S Robert St, Suite C, St Paul, MN 55118 | 2015-03-06 |
| 1225458458 | Shellea J Altman | Dentist | 576 High Ridge Circle, Mendota Heights, MN 55118 | 2014-04-28 |
| Find all providers in zip 55118 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902238231 | Patrick Joseph Parks | Pathology | 2282 Field Stone Dr, Mendota Heights, MN 55120-1918 | 2013-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831627702 | Cade Dylan Arries | Pathology | 420 Delaware St Se # D142, Minneapolis, MN 55455-0341 | 2017-05-23 |
| 1013337773 | Kevin Jee Ha | Pathology | 172 6th St E Apt 1906, Saint Paul, MN 55101-1978 | 2014-04-22 |
| 1538505862 | Mary Louise Ulrickson | Pathology | 824 Westwood Dr S, Golden Valley, MN 55416-3355 | 2013-05-14 |
| 1386872620 | Ronald L Villella | Pathology | 13393 Danube Cir, Rosemount, MN 55068-3168 | 2009-06-25 |
| 1679791230 | Ann Marie Connor | Pathology | 1080 County Rd D W, Apt. 24, Roseville, MN 55126-3766 | 2007-04-20 |
| 1669551693 | Martin L Lipschultz | Pathology | 716 Meadow Ln S, Minneapolis, MN 55416-3417 | 2006-11-02 |
| 1831281641 | Ajay Rawal | Pathology | 640 Jackson St - Mc 11103e, Hehealthpartners Regions Specialty Clinics, St. Paul, MN 55101-2502 | 2006-09-29 |
| 1639284870 | Michael Andrew Linden | Pathology | 420 Deleware St. Se, Mmc 609, Minneapolis, MN 55455 | 2006-08-20 |
| 1568471647 | David Jon Blomberg | Pathology | 1314 S Ridge Rd, Duluth, MN 55804-1472 | 2006-08-06 |
| 1528099538 | Kristi Lee Werdin | Pathology | 2945 Hazelwood St Ste 310, Maplewood, MN 55109-1241 | 2006-07-06 |
| Find all providers with the same taxonomy | ||||
| City | MENDOTA HEIGHTS |
| Zip Code | 55118 |
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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.