Individual provider Active NPI

Thomas G Cohn, MD

  • Interventional Pain Medicine Physician
  • Sartell, MN
National Provider Identifier
1245273390
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
42304 Issued in MN
Practice address
166 19TH Street South
Suite 100
Sartell, MN 56377-2154
Phone
(320) 251-0609
Fax
(320) 251-3806
NPI assigned
Jun 14, 2006
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 42304 MN Primary

Addresses

Primary practice location

166 19TH Street South
Suite 100
Sartell, MN 56377-2154

Mailing address

PO Box 1450
Minneapolis, MN 55485-6035
Phone (952) 542-8553

Other identifiers 1

IdentifierTypeStateIssuer
457430800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329001128 MN Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 6002942091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42304MNMDInterventional Pain Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1245273390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 19TH STREET SOUTH",
            "address_2": "SUITE 100",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-251-0609",
            "fax_number": "320-251-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHN",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MN",
            "license": "42304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "457430800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.