Scott Timothy Reardon (NPI# 1598797896, PAC ID# 3678606241) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1598797896 |
| PAC ID by PECOS | 3678606241 |
| Professional Enrollment ID | I20100803000585 |
| Full Name | Scott Timothy Reardon |
| Organization Legal Name | ST MARYS REGIONAL HEALTH CENTER |
| Address |
1027 Washington Ave Detroit Lakes MN 56501-3409 |
| Phone Number | 2188475611 |
| Gender | M |
| Medical School | UNIVERSITY OF MINNESOTA MEDICAL SCHOOL |
| Graduation Year | 2006 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2062326820 |
| Number of Group Practice Members | 142 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240101 | ESSENTIA HEALTH ST MARYS - DETROIT LAKES |
| 350070 | ESSENTIA HEALTH |
| 241380 | ST JOSEPHS AREA HEALTH SERVICES |
| 241357 | ESSENTIA HEALTH FOSSTON |
| 241313 | ESSENTIA HEALTH ADA |
| Address | Phone | Organization |
|---|---|---|
| 1027 Washington Ave, Detroit Lakes, MN 56501-3409 | 2188475611 | ST MARYS REGIONAL HEALTH CENTER |
| Organization Legal Name | ST MARYS REGIONAL HEALTH CENTER |
| Physicians | 136 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kayse J Aho | Qualified Speech Language Pathologist | St Marys Regional Health Center | 705 Pleasant Ave S, Park Rapids, MN 56470-1440 |
| Kathy Nevins | Nurse Practitioner | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Jonathon R Peterson | Physical Therapy | St Marys Regional Health Center | 212 Aspen Ave Ne, Menahga, MN 56464-3289 |
| Robert A Koshnick | Family Practice | St Marys Regional Health Center | 300 E Main Ave, Frazee, MN 56544-4504 |
| Rose A Haroldson | Physician Assistant | St Marys Regional Health Center | 110 Michigan Ave W, Walker, MN 56484-2274 |
| John J Ragan | Cardiovascular Disease (cardiology) | St Marys Regional Health Center | 114 Frazee St E, Detroit Lakes, MN 56501-3502 |
| Katie C Busker | Certified Registered Nurse Anesthetist (crna) | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Michelle T Thieman | Family Medicine | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Gaurav Suresh Mehta | Family Medicine | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Alexander E Moses | Optometry | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Street Address |
1027 WASHINGTON AVE |
| City | DETROIT LAKES |
| State | MN |
| Zip | 56501-3409 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathy Nevins | Nurse Practitioner | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Katie C Busker | Certified Registered Nurse Anesthetist (crna) | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Michelle T Thieman | Family Medicine | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Gaurav Suresh Mehta | Family Medicine | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Alexander E Moses | Optometry | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Binaya Khanal | Nephrology | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Andrew R Moen | Podiatry | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Hope M Mathern | Nurse Practitioner | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Christopher J Peluso | Physician Assistant | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Jeffrey D Sliper | Certified Registered Nurse Anesthetist (crna) | St Marys Regional Health Center | 1027 Washington Ave, Detroit Lakes, MN 56501-3409 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul W Bender | Chiropractic | 119 Washington Ave, Detroit Lakes, MN 56501-2403 | |
| Juihsien Kao | Psychologist, Clinical | Solutions Behavioral Healthcare Professionals | 1104 W River Rd, Detroit Lakes, MN 56501-2723 |
| Tessie Blake | Psychologist, Clinical | Solutions Behavioral Healthcare Professionals | 1104 W River Rd, Detroit Lakes, MN 56501-2723 |
| Mary Lindstrom Amundson | Clinical Social Worker | Solutions Behavioral Healthcare Professionals | 1104 W River Rd, Detroit Lakes, MN 56501-2723 |
| Chad C Erickson | Psychiatry | Lakeland Mental Health Center Inc | 928 Se 8th St, Detroit Lakes, MN 56501-2839 |
| Audrey A Kolnes | Clinical Social Worker | Lakeland Mental Health Center Inc | 928 Se 8th St, Detroit Lakes, MN 56501-2839 |
| Wanda J Dahlen | Psychologist, Clinical | Lakeland Mental Health Center Inc | 928 Se 8th St, Detroit Lakes, MN 56501-2839 |
| Thomas C Wilson | Chiropractic | Detroit Lakes Chiropractic, PC | 213 State St W, Detroit Lakes, MN 56501-3005 |
| Dustin P Johnson | Chiropractic | Detroit Lakes Chiropractic, PC | 213 State St W, Detroit Lakes, MN 56501-3005 |
| Idriz Kovacevic I | Sleep Medicine | Whitney Sleep Diagnostics and Consultants, LLC | 712 Washington Ave, Detroit Lakes, MN 56501-3012 |
| Find all physicians in zip 56501 | |||
| City | DETROIT LAKES |
| Zip Code | 56501 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | DETROIT LAKES + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Scott Timothy Reardon.
| 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.