Organization Active NPI

Simple Spectrum Services LLC

  • Clinic/Center
  • Edina, MN
National Provider Identifier
1154115806
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SIMPLE SPECTRUM SERVICES LLC
Practice address
4445 77TH St W Ste 106B
Edina, MN 55435-5133
Phone
(612) 682-2569
NPI assigned
Apr 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Ahmed Kadar
Title
Owner
Phone
(612) 682-2569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4445 77TH St W Ste 106B
Edina, MN 55435-5133

Mailing address

4445 77TH St W Ste 106B
Edina, MN 55435-5133

National Provider Directory

National Provider Directory

Locations

4445 77th St W
Ste 106B
Edina, MN 55435
Phone (612) 682-2569

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1154115806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 77TH ST W STE 106B",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 77TH ST W STE 106B",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355133",
            "telephone_number": "612-682-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE SPECTRUM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "KADAR",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-682-2569"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.