Physicians Clinic of Minnesota

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PHYSICIANS CLINIC OF MINNESOTA

Practice address

3801 Bemidji Ave N
Ste 6
Bemidji, MN 56601-4364

Phone

(218) 333-5694

Fax

(218) 444-4728

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Knapp

Title

Clinic Administrator

Phone

(218) 333-5694

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sebastian R. Mangiamele, M.D.

  • General Practice Physician
  • Bemidji, MN
  • NPI 1710944475
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1033176797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 BEMIDJI AVE N",
            "address_2": "STE 6",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014364",
            "telephone_number": "218-333-5694",
            "fax_number": "218-444-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 BEMIDJI AVE N",
            "address_2": "STE 6",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014364",
            "telephone_number": "218-333-5694",
            "fax_number": "218-444-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CLINIC OF MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "218-333-5694",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640127900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Jo Peterson, MS CCC SLP
• Robin Peterson, LPN
• Travis Peterson
• Ross E. Pettit, MD
• Jane Ella Phelps, LADC
• Charles William Picard, OD
• Piece of Mind Counseling Services, PLLC
• Jennifer J Pirkl, LICSW
• Diane Mountain Pittman, MD
• Patrick James Plemel, LADC

• General Practice Physician in Bemidji, MN
• Providers in Bemidji, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.