John D Cervenka, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19785 Issued in MN

Practice address

301 Main St E
Suite 1
New Prague, MN 56071-1803

Phone

(952) 758-1050

Fax

(952) 758-5011

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1720034234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAIN ST E",
            "address_2": "SUITE 1",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711803",
            "telephone_number": "952-758-1050",
            "fax_number": "952-758-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST E",
            "address_2": "SUITE 1",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711803",
            "telephone_number": "952-758-1050",
            "fax_number": "952-758-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVENKA",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "19785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943368600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Jennings Boson, DDS
• Kristen Bowe, FNP-C
• Lori K. Brown, MA
• Lindsay Browning, APRN, AGCNS-BC
• Ricky V Carlson, LPC, NCC, CEAP
• City of New Prague (New Prague Ambulance)
• Coborns Inc (Coborn's Pharmacy #2038)
• Jon Paul Colling, DDS
• Jill Elizabeth Companion
• Jean E Craig, MD

• Family Medicine Physician in New Prague, MN
• Providers in New Prague, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.