Minnesota Neurologic Evaluations LTD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

15205 Issued in MN

Legal business name

MINNESOTA NEUROLOGIC EVALUATIONS LTD

Practice address

5355 320TH St
Cushing, MN 56443-2128

Phone

(218) 575-2097

NPI assigned

Mar 28, 2007

Last updated

Oct 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jyl R Dinville, CCS-P

Title

Physician Reimbursement Specialist

Phone

(402) 397-5462

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1033238308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27015",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681270015",
            "telephone_number": "402-393-9459",
            "fax_number": "402-397-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 320TH ST",
            "city": "CUSHING",
            "state": "MN",
            "postal_code": "564432128",
            "telephone_number": "218-575-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA NEUROLOGIC EVALUATIONS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "DINVILLE",
        "authorized_official_first_name": "JYL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN REIMBURSEMENT SPECIALIST",
        "authorized_official_telephone_number": "402-397-5462",
        "authorized_official_credential": "CCS-P"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "15205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "27T36GA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "663270000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "27T35MI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Annette Klinger
• Sharon R Raugutt, LPCC
• Redemption Psychotherapy Services PLLC

• Neurology Physician in Cushing, MN
• Providers in Cushing, MN by specialty
• Neurology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.