NPIMap

Organization Active NPI

Excellence Community Clinic Center

Doing business as None

  • Preferred Provider Organization
  • Hopkins, MN
National Provider Identifier
1073053997
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
EXCELLENCE COMMUNITY CLINIC CENTER
Doing business as
None
Practice address
105 Blake Rd N Apt 206
Hopkins
Hopkins, MN 55343-8266
Phone
(562) 606-8284
NPI assigned
Feb 24, 2017
Last updated
Feb 24, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCELLENCE COMMUNITY CLINIC CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Abdiqadir Salad HassanNPI 1316396609
Title
Director
Phone
(562) 606-8284

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X NU Primary

Addresses

Primary practice location

105 Blake Rd N Apt 206
Hopkins
Hopkins, MN 55343-8266

Mailing address

105 Blake Rd N Apt 206
Hopkins
Hopkins, MN 55343-8266
Phone (562) 606-8284

Other names 1

  • None Doing business as

National Provider Directory

National Provider Directory
Part of
Excellence Community Clinic Center

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1073053997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BLAKE RD N APT 206",
            "address_2": "HOPKINS",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438266",
            "telephone_number": "562-606-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BLAKE RD N APT 206",
            "address_2": "HOPKINS",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438266",
            "telephone_number": "562-606-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE COMMUNITY CLINIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELLENCE COMMUNITY CLINIC CENTER",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "ABDIQADIR",
        "authorized_official_middle_name": "SALAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "562-606-8284"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.