NPIMap

Organization Active NPI

Patient Readiness Instutute, Inc.

  • Clinical Pathology Physician
  • Minneapolis, MN
National Provider Identifier
1033474267
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology PhysicianTaxonomy code 207ZC0006X
License
37208 Issued in MN
Legal business name
PATIENT READINESS INSTUTUTE, INC.
Practice address
5004 1/2 Xerxes Ave S
Suite 3
Minneapolis, MN 55410-2226
Phone
(612) 224-9913
Fax
(612) 360-2993
NPI assigned
Jul 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Authorized official

Name
Sammi M Boerner
Title
Care Coordinator
Phone
(612) 224-9913

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZB0001X 37208 MN
Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZC0006X 37208 MN Primary
Hematology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZH0000X 37208 MN

Addresses

Primary practice location

5004 1/2 Xerxes Ave S
Suite 3
Minneapolis, MN 55410-2226

Mailing address

5004 1/2 Xerxes Ave S
Suite 3
Minneapolis, MN 55410-2226
Phone (612) 224-9913

Other identifiers 2

IdentifierTypeStateIssuer
387223800MedicaidMN
1114994563OtherMNTYPE 1 NPI

National Provider Directory

National Provider Directory

Locations

5004 Xerxes Ave S
Ste 3
Minneapolis, MN 55410
Phone (612) 224-9913

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1033474267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 1/2 XERXES AVE S",
            "address_2": "SUITE 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102226",
            "telephone_number": "612-224-9913",
            "fax_number": "612-360-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 1/2 XERXES AVE S",
            "address_2": "SUITE 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102226",
            "telephone_number": "612-224-9913",
            "fax_number": "612-360-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT READINESS INSTUTUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "BOERNER",
        "authorized_official_first_name": "SAMMI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CARE COORDINATOR",
        "authorized_official_telephone_number": "612-224-9913"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MN",
            "license": "37208",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": "MN",
            "license": "37208",
            "primary": true
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "MN",
            "license": "37208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387223800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1114994563",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.