NPIMap

Organization Active NPI

Indian Health Board of Minneapolis, Inc Anishinabe

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
National Provider Identifier
1043591357
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
6115875 Issued in MN
Legal business name
INDIAN HEALTH BOARD OF MINNEAPOLIS, INC ANISHINABE
Practice address
3100 E 28TH St
Minneapolis, MN 55406-1601
Phone
(612) 721-9800
Fax
(612) 721-7870
NPI assigned
Aug 31, 2011
Organization subpart
Yes
Parent organization
INDIAN HEALTH BOARD OF MINNEAPOLIS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Authorized official

Name
Patrick Rock, M.D.
Title
Ceo
Phone
(612) 721-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 6115875 MN Primary

Addresses

Primary practice location

3100 E 28TH St
Minneapolis, MN 55406-1601

Mailing address

1315 E 24TH St
Minneapolis, MN 55404-3975
Phone (612) 721-9800

National Provider Directory

National Provider Directory
Tax ID family
Indian Health Board of Minneapolis Inc2 organizations share this tax ID, including this one
Part of
Indian Health Board of Minneapolis Inc

Other organizations with this tax ID 1

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

Locations

3100 E 28th St
Minneapolis, MN 55406
Phone (612) 668-5000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1043591357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043975",
            "telephone_number": "612-721-9800",
            "fax_number": "612-721-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061601",
            "telephone_number": "612-721-9800",
            "fax_number": "612-721-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN HEALTH BOARD OF MINNEAPOLIS, INC ANISHINABE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIAN HEALTH BOARD OF MINNEAPOLIS, INC",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "ROCK",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-721-9800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MN",
            "license": "6115875",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 31, 2011; 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.