NPIMap

Organization Active NPI

Paxxon Healthcare Services LLC

  • Physical Therapist
  • St Louis Park, MN
National Provider Identifier
1083978894
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PAXXON HEALTHCARE SERVICES LLC
Practice address
3663 Park Center Blvd
St Louis Park, MN 55416-2532
Phone
(952) 925-6231
Fax
(952) 926-6823
NPI assigned
Jun 26, 2012
Last updated
Jun 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Authorized official

Name
Roger Berkley
Title
President
Phone
(516) 510-9884

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

3663 Park Center Blvd
St Louis Park, MN 55416-2532

Mailing address

10 New King St
Suite 105
White Plains, NY 10604-1205
Phone (914) 390-9880

National Provider Directory

National Provider Directory
Tax ID family
Paxxon Healthcre Serv LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1083978894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NEW KING ST",
            "address_2": "SUITE 105",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106041205",
            "telephone_number": "914-390-9880",
            "fax_number": "914-390-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 PARK CENTER BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162532",
            "telephone_number": "952-925-6231",
            "fax_number": "952-926-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAXXON HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "BERKLEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-510-9884"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.