Intrepid USA

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

326853 Issued in MN

Legal business name

INTREPID USA

Practice address

5775 Wayzata Blvd Ste 540
St Louis Park, MN 55416-1230

Phone

(952) 513-5400

Fax

(952) 513-5444

NPI assigned

Nov 14, 2014

Organization subpart

Yes

Parent organization

INTREPID USAAs reported in NPPES

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

Authorized official

Name

Alicia A Cline

Title

Administrator

Phone

(952) 513-5400

Specialties & licenses 1

Addresses

Other names 1

• Intrepid USA Former legal business name

Part of

Becklund Health Care Su

Locations

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1023414281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 540",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161230",
            "telephone_number": "952-513-5400",
            "fax_number": "952-513-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 540",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161230",
            "telephone_number": "952-513-5400",
            "fax_number": "952-513-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID USA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTREPID USA",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "CLINE",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "952-513-5400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "326853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intrepid USA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.