Organization Active NPI

Homeopathic Medical Clinic

  • Health Service Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1235381476
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
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

Updated by the provider on Oct 21, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2002688MedicaidMN

National Provider Directory

National Provider Directory

NPI 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

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.

Verify at the official NPI Registry.