Upper Midwest Organ Procurement Organization, Inc.

Primary specialty

Organ Procurement OrganizationTaxonomy code 335U00000X

Legal business name

UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION, INC.

Doing business as

LifeSource

Practice address

2225 W River Rd
Minneapolis, MN 55411-2228

Phone

(612) 800-6100

NPI assigned

Oct 13, 2021

Last updated

Oct 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Peter David Farstad

Title

Chief Administrative Officer

Phone

(612) 800-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LifeSource Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1174285423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 W RIVER RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112228",
            "telephone_number": "612-800-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 W RIVER RD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112228",
            "telephone_number": "612-800-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "FARSTAD",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "612-800-6100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335U00000X",
            "taxonomy_group": "",
            "desc": "Organ Procurement Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "24-P001",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkabba@life-source.org",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "2225 W River Rd",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554112228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LifeSource",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Organ Procurement Organization in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Organ Procurement Organization in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.