Active NPI
Central Medical Clinic PLLC
- Pain Medicine Physician
- Saint Paul, MN
National Provider Identifier
1174876643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 37899
- Legal business name
- CENTRAL MEDICAL CLINIC PLLC
- Practice address
- 393 Dunlap St N
Suite LL34
Saint Paul, MN 55104-4200 - Phone
- (651) 644-6002
- NPI assigned
- Oct 22, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alfonso Morales-Utrilla, M.D.
- Title
- Medical Director
- Phone
- (651) 644-6002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 37899 | MN | Primary |
Addresses
Primary practice location
393 Dunlap St N
Suite LL34
Saint Paul, MN 55104-4200
Mailing address
393 Dunlap St N
Suite LL34
Saint Paul, MN 55104-4200
Phone (651) 644-6002
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1383264000000",
"number": "1174876643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 DUNLAP ST N",
"address_2": "SUITE LL34",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044200",
"telephone_number": "651-644-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 DUNLAP ST N",
"address_2": "SUITE LL34",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044200",
"telephone_number": "651-644-6002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL MEDICAL CLINIC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-22",
"last_updated": "2013-11-01",
"status": "A",
"authorized_official_last_name": "MORALES-UTRILLA",
"authorized_official_first_name": "ALFONSO",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "651-644-6002",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": "MN",
"license": "37899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
- Centerpoint Care Inc
- Centerpointe Behavioral Health Minneapolis LLC
- Central Golden Care Services Inc.
- Central Internal Medicine Associates PA
- Central Medical Clinic LLC
- Central Medical Clinic, PLLC.
- Central Medical Wellness & Regeneration
- Central Medical Wellness Inc
- Central Towers Limited Partnership
- Ariel Roman Centurion, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.