NPIMap

Organization Active NPI

Metro Therapy Special Children'S Clinic, Inc

  • Occupational Therapist
  • Fridley, MN
National Provider Identifier
1144587023
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
METRO THERAPY SPECIAL CHILDREN'S CLINIC, INC
Practice address
5155 E River Rd Ste 403
Fridley, MN 55421-3777
Phone
(762) 572-2519
Fax
(763) 572-2616
NPI assigned
Apr 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Mr. Patrick Timothy Sullivan
Title
President
Phone
(763) 572-2519

Specialties & licenses 2

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

Addresses

Primary practice location

5155 E River Rd Ste 403
Fridley, MN 55421-3777

Mailing address

5155 E River Rd Ste 403
Fridley, MN 55421-3777
Phone (762) 572-2519

National Provider Directory

National Provider Directory

Locations

5155 E River Rd
Ste 403
Fridley, MN 55421
Phone (763) 450-9400

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1144587023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD STE 403",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554213777",
            "telephone_number": "762-572-2519",
            "fax_number": "763-572-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 E RIVER RD STE 403",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554213777",
            "telephone_number": "762-572-2519",
            "fax_number": "763-572-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO THERAPY SPECIAL CHILDREN'S CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-572-2519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.