Basic Information
| Provider Information | |||||||||
| NPI: | 1326046731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELMERS | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | RODNEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 MARTIN LUTHER KING DR | ||||||||
| Address2: | |||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560016460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073856500 | ||||||||
| FaxNumber: | 5073856510 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 MARTIN LUTHER KING DR | ||||||||
| Address2: | |||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560016460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073856500 | ||||||||
| FaxNumber: | 5073856510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2005 | ||||||||
| LastUpdateDate: | 09/02/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 18374 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | 18374 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207QS0010X | 18374 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0073197 | 05 | IA | MEDICAID | 115476 | 01 | MN | MINNESOTA UCARE | OTHER | 917782500 | 05 | MN | MEDICAID |