Randall A Kenninger (NPI# 1013934785, PAC ID# 2961695218) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1013934785 |
| PAC ID by PECOS | 2961695218 |
| Professional Enrollment ID | I20101020000050 |
| Full Name | Randall A Kenninger |
| Organization Legal Name | SANFORD MEDICAL CENTER FARGO |
| Address |
2400 32nd Ave S Fargo ND 58103-5800 |
| Phone Number | 7012348800 |
| Gender | M |
| Medical School | UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8426967803 |
| Number of Group Practice Members | 714 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350011 | SANFORD MEDICAL CENTER FARGO |
| 240100 | SANFORD MEDICAL CENTER BEMIDJI |
| Address | Phone | Organization |
|---|---|---|
| 2400 32nd Ave S, Fargo, ND 58103-5800 | 7012348800 | SANFORD MEDICAL CENTER FARGO |
| Organization Legal Name | SANFORD MEDICAL CENTER FARGO |
| Physicians | 563 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica M Smolen | Nurse Practitioner | Sanford Medical Center Fargo | 4000 28th Ave S, Moorhead, MN 56560-7460 |
| Ahmed M Kassem | Ophthalmology | Sanford Medical Center Fargo | 1717 University Dr S, Fargo, ND 58103-4939 |
| Sugong Chen | General Surgery | Sanford Medical Center Fargo | 621 Demers Ave, East Grand Forks, MN 56721-1812 |
| Ashley Heule | Certified Registered Nurse Anesthetist (crna) | Sanford Medical Center Fargo | 5225 23rd Ave S, Fargo, ND 58104-7927 |
| Amy Iva Stevahn | Nurse Practitioner | Sanford Medical Center Fargo | 2801 University Dr S, Fargo, ND 58103-6029 |
| Cynthia Vingelen | Nurse Practitioner | Sanford Medical Center Fargo | 1220 Sheyenne St, West Fargo, ND 58078-2637 |
| Scott B Phillips | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Amanda Helmer | Nurse Practitioner | Sanford Medical Center Fargo | 1111 Harwood Dr S, Fargo, ND 58104-4603 |
| Lakshmi K Pathak | Internal Medicine | Sanford Medical Center Fargo | 520 Chautauqua Blvd, Valley City, ND 58072-3145 |
| Sonja A Lien | Family Practice | Sanford Medical Center Fargo | 2400 32nd S Ave, Sanford Southpointe Clinic, Fargo, ND 58103-5800 |
| Street Address |
2400 32ND AVE S |
| City | FARGO |
| State | ND |
| Zip | 58103-5800 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jason C Myrmoe | Family Medicine | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Eric C Pearson | Family Medicine | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Dana L Stegmiller | Physician Assistant | Sanford Medical Center Fargo | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Laurie A Somerville | Physician Assistant | Sanford Medical Center Fargo | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Darshan S Khangura | Endocrinology | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Gerald G Gross | Hematology/oncology | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| James B Buhr | Family Medicine | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Susan L Scarberry | Neurology | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Andrea M Beiseker | Nurse Practitioner | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Bhargav M Mistry | Undefined Physician Type (specify) | Sanford Clinic North | 2400 32nd Ave S, Fargo, ND 58103-5800 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary E Johnson | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Mark G Tufte | Optometry | Mark Tufte Od PC | 1801 45th St S, Suite G, Fargo, ND 58103-0801 |
| Anthony Heath Charbonneau | Physical Therapy | Total Balance Physical Therapy and Fitness LLC | 4041 Main Ave, Fargo, ND 58103-1145 |
| Scott B Phillips | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Marcus F Keep | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Behzad S Sabit | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Abdul A Baker | Neurosurgery | Sanford Clinic North | 700 1st Ave S, Fargo, ND 58103-1802 |
| Michael David Manchak | Neurology | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tahereh Keshavarz | Physician Assistant | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Tong Yang | Neurosurgery | Sanford Medical Center Fargo | 700 1st Ave S, Fargo, ND 58103-1802 |
| Find all physicians in zip 58103 | |||
| City | FARGO |
| Zip Code | 58103 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FARGO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Randall A Kenninger.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.