Organization Active NPI

Conrad L Meints & Associate

  • Foot Surgery Podiatrist
  • Duluth, MN
National Provider Identifier
1154559144
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
532 Issued in MN
Legal business name
CONRAD L MEINTS & ASSOCIATE
Practice address
324 W Superior St
Suite 517
Duluth, MN 55802-1760
Phone
(218) 722-0626
Fax
(218) 722-4403
NPI assigned
Jun 29, 2009
Last updated
Jun 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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

Authorized official

Name
Sarah Lynn Soderholm
Title
Office Manager
Phone
(218) 722-0326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 532 MN Primary

Addresses

Primary practice location

324 W Superior St
Suite 517
Duluth, MN 55802-1760

Mailing address

324 W Superior St
Suite 517
Duluth, MN 55802-1760
Phone (218) 722-0626

Other identifiers 4

IdentifierTypeStateIssuer
77342MEOtherMNBLUE CROSS BLUE SHIELD OF MINNESOTA
2700690OtherMNMEDICA
767218700MedicaidMN
480034106OtherMNPALMETTO GBA RAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

324 W Superior St
Ste 517
Duluth, MN 55802
Phone (218) 722-0326

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1154559144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "SUITE 517",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021760",
            "telephone_number": "218-722-0626",
            "fax_number": "218-722-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "SUITE 517",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021760",
            "telephone_number": "218-722-0626",
            "fax_number": "218-722-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD L MEINTS & ASSOCIATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "SODERHOLM",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "218-722-0326"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MN",
            "license": "532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MINNESOTA",
            "identifier": "77342ME",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2700690",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767218700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "480034106",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.