Active NPI
Homeopathic Medical Clinic
- Health Service Clinic/Center
- Minneapolis, MN
National Provider Identifier
1235381476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- HOMEOPATHIC MEDICAL CLINIC
- Practice address
- 4201 Excelsior Blvd
Minneapolis, MN 55416-4728 - Phone
- (952) 933-8900
- Fax
- (952) 945-9536
- NPI assigned
- Oct 21, 2008
- 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. Jacob I Mirman, MD
- Title
- President
- Phone
- (952) 933-8900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Primary |
Addresses
Primary practice location
4201 Excelsior Blvd
Minneapolis, MN 55416-4728
Mailing address
4201 Excelsior Blvd
Minneapolis, MN 55416-4728
Phone (952) 933-8900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2002688 | Medicaid | MN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1224547200000",
"number": "1235381476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 EXCELSIOR BLVD",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164728",
"telephone_number": "952-933-8900",
"fax_number": "952-945-9536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 EXCELSIOR BLVD",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164728",
"telephone_number": "952-933-8900",
"fax_number": "952-945-9536"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOMEOPATHIC MEDICAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A",
"authorized_official_last_name": "MIRMAN",
"authorized_official_first_name": "JACOB",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "952-933-8900",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2002688",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
- Jonathan Chase Homans, M.D.
- Home Drywall & Painting LLC (Home Drywall & Construction)
- Home Health Care LLC
- Homeboundtransportation
- Homeland Health Specialists Inc
- Homes of Compassion Recuperative Care LLC
- Homesure Housing Services LLC (HomeSure Housing Services)
- Amber Marie Honcharoff, CCC-SLP
- Maria Fernanda Honebrink, APRN, CNM
- Theodore John Honebrink, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.