Northern Pines Orthopaedic Center, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

0-278-043-264 Issued in MN

Legal business name

NORTHERN PINES ORTHOPAEDIC CENTER, LLC

Practice address

111 Golf Course Rd
Suite 3
Grand Rapids, MN 55744-3526

Phone

(218) 326-6677

Fax

(218) 326-0400

NPI assigned

Aug 22, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Daniel L Baker, M.D.

Title

C E O

Phone

(218) 326-6677

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1124427414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GOLF COURSE RD",
            "address_2": "SUITE 3",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443526",
            "telephone_number": "218-326-6677",
            "fax_number": "218-326-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GOLF COURSE RD",
            "address_2": "SUITE 3",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443526",
            "telephone_number": "218-326-6677",
            "fax_number": "218-326-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PINES ORTHOPAEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "C E O",
        "authorized_official_telephone_number": "218-326-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "MN",
            "license": "0-278-043-264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MN REGISTRATION",
            "identifier": "1068",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.