NPIMap

Organization Active NPI

Little Canada Medical Clinic

  • Primary Care Clinic/Center
  • Little Canada, MN
National Provider Identifier
1174836597
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
20780 Issued in MN
Legal business name
LITTLE CANADA MEDICAL CLINIC
Practice address
75 Little Canada Rd W
Little Canada, MN 55117-1362
Phone
(651) 481-1119
Fax
(651) 481-1476
NPI assigned
Jul 15, 2010
Last updated
Jul 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Dr. James William Allan, M.D.NPI 1649297151
Title
President
Phone
(651) 481-1119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 20780 MN Primary

Addresses

Primary practice location

75 Little Canada Rd W
Little Canada, MN 55117-1362

Mailing address

75 Little Canada Rd W
Little Canada, MN 55117-1362
Phone (651) 481-1119

Other identifiers 4

IdentifierTypeStateIssuer
D80937OtherMNUPIN
0123164OtherMNMEDICA
20504LIOtherMNBLUE CROSS BLUE SHEILD
263273000MedicaidMN

National Provider Directory

National Provider Directory

Locations

75 Little Canada Rd W
Little Canada, MN 55117
Phone (651) 202-3491

Practitioners & affiliated clinicians

Practitioners 2

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": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1174836597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LITTLE CANADA RD W",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171362",
            "telephone_number": "651-481-1119",
            "fax_number": "651-481-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 LITTLE CANADA RD W",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171362",
            "telephone_number": "651-481-1119",
            "fax_number": "651-481-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE CANADA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "ALLAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-481-1119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": "20780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "D80937",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0123164",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "20504LI",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263273000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Canada, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.