Active NPI
Good Clinic MN PLLC
- Primary Care Clinic/Center
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- GOOD CLINIC MN PLLC
- Practice address
- 4712 Excelsior Blvd
St Louis Park, MN 55416-3008 - Phone
- (844) 383-8689
- NPI assigned
- Sep 30, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kevin Lee Smith, DNP
- Title
- Chief Nurse Practitioner Officer
- Phone
- (763) 639-5327
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
4712 Excelsior Blvd
St Louis Park, MN 55416-3008
Mailing address
1660 Highway 100 S Ste 432
St Louis Park, MN 55416-1533
Other practice location 1
845 Vikings Pkwy Ste B
Eagan, MN 55121-1002
Phone (651) 650-0500
Other practice location 2
7881 Main St N Ste 538
Maple Grove, MN 55369-7082
Phone (651) 650-0400
Other practice location 3
246 Snelling Ave S Ste 1
Saint Paul, MN 55105-2019
Phone (651) 650-0300
Other practice location 4
307 1St Ave NE
Minneapolis, MN 55413-5001
Phone (763) 639-5327
Other practice location 5
12900 Technology Dr Ste 140
Eden Prairie, MN 55344-2638
Phone (844) 383-8689 ext. 704
Other names 1
- The Good Clinic
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2230068 | Good Clinic MN PLLC | Certificate of waiver | Jul 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
12900 Technology Dr
Ste 140
Eden Prairie, MN 55344
Phone 8443838689 ext. 704
7881 Main St N
Maple Grove, MN 55369
7811 Main St N
Maple Grove, MN 55369
7881 Main St N
Ste 538
Maple Grove, MN 55369
Phone (651) 650-0400
315 1st Ave NE
Minneapolis, MN 55413
4190 Vinewood Ln N
Ste 111567
Plymouth, MN 55442
845 Vikings Pkwy
Saint Paul, MN 55121
845 Vikings Pkwy
#B
Saint Paul, MN 55121
1660 Highway 100 S
Ste 432
St Louis Park, MN 55416
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Saint Paul, MN
- NPI 1891303004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601424000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1642118400000",
"number": "1003423252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 HIGHWAY 100 S STE 432",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554161533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4712 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554163008",
"telephone_number": "844-383-8689"
}
],
"practiceLocations": [
{
"address_1": "845 Vikings Pkwy Ste B",
"address_purpose": "LOCATION",
"city": "Eagan",
"state": "MN",
"postal_code": "551211002",
"country_code": "US",
"telephone_number": "651-650-0500",
"fax_number": "651-650-0501",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7881 Main St N Ste 538",
"address_purpose": "LOCATION",
"city": "Maple Grove",
"state": "MN",
"postal_code": "553697082",
"country_code": "US",
"telephone_number": "651-650-0400",
"fax_number": "651-650-0401",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "246 Snelling Ave S Ste 1",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551052019",
"country_code": "US",
"telephone_number": "651-650-0300",
"fax_number": "651-650-0301",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "307 1ST AVE NE",
"address_purpose": "LOCATION",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554135001",
"country_code": "US",
"telephone_number": "763-639-5327",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12900 Technology Dr Ste 140",
"address_purpose": "LOCATION",
"city": "Eden Prairie",
"state": "MN",
"postal_code": "553442638",
"country_code": "US",
"telephone_number": "844-383-8689 x704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GOOD CLINIC MN PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-09-30",
"last_updated": "2022-01-14",
"certification_date": "2022-01-11",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "CHIEF NURSE PRACTITIONER OFFICER",
"authorized_official_telephone_number": "763-639-5327",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DNP"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Good Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "The Good Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.