NPIMap

Organization Active NPI

Medexpress Primary Care Minnesota, P.C.

Doing business as The Well - Minnetonka, Bren Rd E

  • General Practice Physician
  • Minnetonka, MN
National Provider Identifier
1023534963
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEDEXPRESS PRIMARY CARE MINNESOTA, P.C.
Doing business as
The Well - Minnetonka, Bren Rd E
Practice address
9700 Health Care LN
Minnetonka, MN 55343-4522
Phone
(952) 936-7043
Fax
(952) 936-7042
NPI assigned
Aug 22, 2017
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Joy Kimball
Title
Contract Manager
Phone
(804) 339-3933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

9700 Health Care LN
Minnetonka, MN 55343-4522

Mailing address

423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500

Other names 1

  • The Well - Minnetonka, Bren Rd E Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medexpress Primary Care Minnesota PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1023534963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BLVD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081351",
            "telephone_number": "304-225-2500",
            "fax_number": "304-985-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 HEALTH CARE LN",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553434522",
            "telephone_number": "952-936-7043",
            "fax_number": "952-936-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS PRIMARY CARE MINNESOTA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "804-339-3933"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Well - Minnetonka, Bren Rd E",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Well - Minnetonka, Bren Rd E",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.