NPIMap

Organization Active NPI

Center for Victims of Torture

  • Community/Behavioral Health Agency
  • Saint Paul, MN
National Provider Identifier
1124111729
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CENTER FOR VICTIMS OF TORTURE
Practice address
649 Dayton Ave
Saint Paul, MN 55104-6631
Phone
(612) 436-4840
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Ka Thao
Title
Medical Billing Coordinator
Phone
(612) 436-4860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

649 Dayton Ave
Saint Paul, MN 55104-6631

Mailing address

649 Dayton Ave
Saint Paul, MN 55104-6631
Phone (612) 436-4840

Other practice location 1

555 Park St Ste 310
Saint Paul, MN 55103-2112
Phone (651) 478-7897

Other practice location 2

110 2nd St S Ste 303
Waite Park, MN 56387-1314
Phone (320) 217-5052

Other identifiers 4

IdentifierTypeStateIssuer
22572OtherFMHEALTH PARTNERS
120700OtherMNUCARE
243513600MedicaidMN
318LOCEOtherMNMN BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607000109 MN Part B Supplier - Clinic/Group Practice 4688656291 Receives reassigned benefits from 9 practitioners
Practice locations: Waite Park, MN; Saint Paul, MN

National Provider Directory

National Provider Directory
Tax ID family
Center for Victims of Torture Clinic Partnership7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2356 University Ave W
Ste 430
Saint Paul, MN 55114

555 Park St
Ste 310
Saint Paul, MN 55103
Phone (651) 478-7897

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1124111729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 DAYTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046631",
            "telephone_number": "612-436-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 DAYTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046631",
            "telephone_number": "612-436-4840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Park St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551032112",
            "country_code": "US",
            "telephone_number": "651-478-7897",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 2nd St S Ste 303",
            "address_purpose": "LOCATION",
            "city": "Waite Park",
            "state": "MN",
            "postal_code": "563871314",
            "country_code": "US",
            "telephone_number": "320-217-5052",
            "fax_number": "612-436-4860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR VICTIMS OF TORTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "THAO",
        "authorized_official_first_name": "KA",
        "authorized_official_title_or_position": "MEDICAL BILLING COORDINATOR",
        "authorized_official_telephone_number": "612-436-4860"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "22572",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "120700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243513600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS",
            "identifier": "318LOCE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.