Organization Active NPI

St. Paul Surgeons, LTD.

  • Specialist
  • Maplewood, MN
National Provider Identifier
1083679484
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
53 Issued in MN
Legal business name
ST. PAUL SURGEONS, LTD.
Practice address
1655 Beam Ave
Ste 302
Maplewood, MN 55109-1163
Phone
(651) 227-6351
Fax
(651) 227-1134
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Authorized official

Name
Dr. Peter H Kelly, M.D.
Title
Partner
Phone
(651) 227-6351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 53 MN Primary

Addresses

Primary practice location

1655 Beam Ave
Ste 302
Maplewood, MN 55109-1163

Mailing address

1655 Beam Ave
Ste 302
Maplewood, MN 55109-1163
Phone (651) 227-6351

National Provider Directory

National Provider Directory

Locations

1655 Beam Ave
Ste 302
Saint Paul, MN 55109
Phone (651) 227-6351

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1083679484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 BEAM AVE",
            "address_2": "STE 302",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091163",
            "telephone_number": "651-227-6351",
            "fax_number": "651-227-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BEAM AVE",
            "address_2": "STE 302",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091163",
            "telephone_number": "651-227-6351",
            "fax_number": "651-227-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PAUL SURGEONS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "651-227-6351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "53",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.