Southdale Medical Partners Corporation

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

SOUTHDALE MEDICAL PARTNERS CORPORATION

Practice address

902 Inwood Ave N Ste 902
Oakdale, MN 55128-6625

Phone

(952) 999-4049

NPI assigned

Apr 1, 2021

Organization subpart

No

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

Authorized official

Name

Mitchell Paul Brandt

Title

Administrator

Phone

(612) 961-4322

Specialties & licenses 2

Addresses

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: merlinbrown@tdhsp-mn.direct.office.nextgen.com

Practitioners 1

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

• Merlin Emery Brown, MD

  • Internal Medicine Physician
  • Edina, MN
  • NPI 1053317354
  NPD (past)

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1043898778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 INWOOD AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551286625",
            "telephone_number": "651-815-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 INWOOD AVE N STE 902",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286625",
            "telephone_number": "952-999-4049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 France Ave S Ste 350",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352159",
            "country_code": "US",
            "telephone_number": "952-999-4049",
            "fax_number": "952-999-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHDALE MEDICAL PARTNERS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-01",
        "last_updated": "2023-05-03",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-961-4322"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "merlinbrown@TDHSP-MN.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6565 France Ave S Ste 350",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554352159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Primary Care Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.