Central Medical Clinic, PLLC.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1123204 Issued in MN

Legal business name

CENTRAL MEDICAL CLINIC, PLLC.

Practice address

393 Dunlap St N
LL34
Saint Paul, MN 55104-4200

Phone

(651) 644-6002

Fax

(651) 647-1647

NPI assigned

Mar 6, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Christine Morales

Title

Clinic Director

Phone

(651) 644-6002

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1053704635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N",
            "address_2": "LL34",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044200",
            "telephone_number": "651-644-6002",
            "fax_number": "651-647-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N",
            "address_2": "LL34",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044200",
            "telephone_number": "651-644-6002",
            "fax_number": "651-647-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MEDICAL CLINIC, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "651-644-6002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1123204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Central Towers Limited Partnership
• Ariel Roman Centurion, MD
• Cerenity Senior Care

• Medical Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.