Provider Demographics
NPI:1124046933
Name:NESS, JOHN A (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:NESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 WAYZATA BLVD E STE 200
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2513
Mailing Address - Country:US
Mailing Address - Phone:763-559-4500
Mailing Address - Fax:763-559-1733
Practice Address - Street 1:935 WAYZATA BLVD E STE 200
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2513
Practice Address - Country:US
Practice Address - Phone:763-559-4500
Practice Address - Fax:763-559-1733
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN363792086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1324452OtherMEDICA
249000020OtherMETRAHEALTH
249000023OtherMETRAHEALTH MPIN
111019OtherUCARE
1324439OtherMEDICA
532002OtherP ONE
53242MIOtherBCBS
111041OtherUCARE
54385HEOtherBCBS
56657SMOtherBCBS
01271SCOtherBCBS
1324451OtherMEDICA
07537OtherMETRAHEALTH MPIN
532001OtherP ONE
108167OtherUCARE
111041OtherUCARE
D75422Medicare UPIN
D80188Medicare UPIN
53242MIOtherBCBS
111019OtherUCARE