MR. LEE RICHARD POTRATZ (NPI# 1891787131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891787131 |
Entity Type | Individual |
Full Name | MR. LEE RICHARD POTRATZ |
Credential | PA-C, ATC |
Practice Address |
1300 Anne St Nw Bemidji MN 56601-5103 |
Mailing Address |
1233 34th St Nw Bemidji MN 56601-5112 |
Practice Telephone | 2187519746 |
Mailing Telephone | 2183335171 |
Enumeration Date | 2005-08-22 |
Last Update Date | 2019-10-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1402 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 363A00000X | Physician Assistant | 10848 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10848 | MN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1300 ANNE ST NW |
City | BEMIDJI |
State | MN |
Zip Code | 56601-5103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922090901 | Marvin R Fetter | Orthopaedic Surgery | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2005-08-17 |
1679129555 | Ashley Marie Wavrin | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-08-15 |
1649824996 | Angela Halvorson | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-25 |
1114589348 | Rachel Marie Vesta | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-07-09 |
1407419419 | Ethan Axtman | Nurse Practitioner | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2019-04-16 |
1053895201 | Jarad Syrstad | Physical Therapist | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-23 |
1851874416 | Kimberly Miller | Physician Assistant | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-09-10 |
1780175752 | Billie Jo Dressing | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-05-24 |
1386142818 | Andrea May Lucca | Social Worker | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-30 |
1356859979 | Andrew William Rook | Registered Nurse | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2018-01-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
Find all providers in zip 56601 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801942750 | Darren D Pagnac | Physician Assistant | 3807 Greenleaf Ave Nw, Bemidji, MN 56601-5817 | 2007-01-25 |
1770639635 | Annetta M Shaw | Physician Assistant | 3807 Greenleaf Ave Nw, Bemidji, MN 56601-5817 | 2007-01-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194120204 | Nathan C Clapper | Physician Assistant | 3580 Arcade St Ste 100, Vadnais Heights, MN 55127-7135 | 2014-10-31 |
1003180555 | Elizabeth K Saterenzoller | Physician Assistant | 1015 Marsh Street, Mankato, MN 56002-8673 | 2012-03-01 |
1477824472 | Andrea Jo Pitzl | Physician Assistant | 3208 36th Ave Ne, St Anthony, MN 55418-1713 | 2012-01-23 |
1447560693 | Jeanine Marie Edstrom | Physician Assistant | 1185 Town Centre Dr Ste 200, Eagan, MN 55123-1343 | 2010-10-20 |
1841504792 | Michelle R Aumock | Physician Assistant | 8100 W 78th Street, Ste 230, Edina, MN 55439 | 2010-08-03 |
1194042390 | Gerald Frederick Anderson | Physician Assistant | 4060 Haines Rd, #104, Duluth, MN 55811-1746 | 2010-04-27 |
1558683904 | Oswaldo Serge | Physician Assistant | 4036 3rd St Nw, Rochester, MN 55901-7564 | 2010-02-25 |
1417288945 | Amanda Kay Johnson | Physician Assistant | 201 W Center St Ei-01 Surgical Assistant, Rochester, MN 55902-3003 | 2010-01-22 |
1790922755 | Jenelle Cecilia Rock | Physician Assistant | 1950 Northwestern Ave S, Suite 102, Stillwater, MN 55082-7590 | 2009-01-13 |
1174775514 | Nathan J Nistler | Physician Assistant | 3580 Arcade Stq, Vadnais Heights, MN 55127-7135 | 2008-10-16 |
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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.