John William Cheesebro, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

366 Issued in MN

Practice address

2805 Campus Dr Ste 225
Plymouth, MN 55441-2678

Phone

(612) 788-8778

Fax

(612) 869-3473

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minnesota Eye Consultants, PA

  • Ophthalmology Physician
  • Bloomington, MN
  • NPI 1508839879
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1144333667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 CAMPUS DR STE 225",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412678",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEESEBRO",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR DEFENSE ID",
            "identifier": "0541840001",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323225500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER ID",
            "identifier": "271055",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS PROVIDER #",
            "identifier": "HP13053",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER ID",
            "identifier": "11691MI",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "411695192",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine S Chang, MD
• Scott Chapman, CMT
• Benjamin Paul Chaput
• Kristine M Chaudet, MD
• Aisha B. Chaudhry, MD
• Cindy GX Chen, PH.D
• Alfred P. Chiang, D.O.
• Wendy L Chiodo-Backer-Francis, RN
• Vivek Babu Chittineni
• Cynthia Chiu, PHARMD

• Podiatrist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.