Active NPI
Christopher William Duesman, PA-C
- Physician Assistant
- Woodbury, MN
National Provider Identifier
1750379103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9506
- Practice address
- 6025 Lake Rd
Suite 200
Woodbury, MN 55125-1712 - Phone
- (651) 999-6800
- Fax
- (651) 999-6830
- NPI assigned
- Oct 10, 2005
- Last updated
- Sep 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9506 | MN | Primary |
Addresses
Primary practice location
6025 Lake Rd
Suite 200
Woodbury, MN 55125-1712
Mailing address
6025 Lake Rd
Suite 200
Woodbury, MN 55125-1712
Phone (651) 999-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 570663700 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9506 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1750379103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6025 LAKE RD",
"address_2": "SUITE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251712",
"telephone_number": "651-999-6800",
"fax_number": "651-999-6830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6025 LAKE RD",
"address_2": "SUITE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251712",
"telephone_number": "651-999-6800",
"fax_number": "651-999-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUESMAN",
"first_name": "CHRISTOPHER",
"middle_name": "WILLIAM",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9506",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "570663700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.