Park Nicollet

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PARK NICOLLET

Practice address

9555 Upland LN N
Maple Grove, MN 55369-4485

Phone

(952) 993-1440

NPI assigned

Jul 11, 2016

Organization subpart

No

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

Authorized official

Name

Bernt Helgaas, M.D.

Title

Medical Director Park Nicollet MGRC

Phone

(952) 993-1440

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Park Nicollet2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Park Nicollet

  • Clinic/Center
  • Maple Grove, MN
  • NPI 1982150728
  NPD tax ID

Locations

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1174975528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7102 OLIVE LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113573",
            "telephone_number": "763-494-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 UPLAND LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694485",
            "telephone_number": "952-993-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "HELGAAS",
        "authorized_official_first_name": "BERNT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR PARK NICOLLET MGRC",
        "authorized_official_telephone_number": "952-993-1440",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany T Panait, M.D.
• Catherine Pandiscio, PA-C
• Amanda Maree Paradis, PA-C
• Paragon Residential Treatment for Youth LLC
• Marc Andrew Parenteau, MD
• Park Nicollet
• Park Nicollet Clinic
• Park Nicollet Health Care Products
• Park Nicollet Methodist Hospital
• Byung-Chul Park, DPT

• Clinic/Center in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.