Organization Active NPI

Parkway Clinic PLLC

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1245914530
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PARKWAY CLINIC PLLC
Practice address
721 Snelling Ave S
Saint Paul, MN 55116-3332
Phone
(651) 690-1311
NPI assigned
Jun 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Emily Resch, MDNPI 1437561453
Title
Physician
Phone
(612) 759-9298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

721 Snelling Ave S
Saint Paul, MN 55116-3332

Mailing address

721 Snelling Ave S
Saint Paul, MN 55116-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250605001602 MN Part B Supplier - Clinic/Group Practice 9133638588 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

721 Snelling Ave S
Saint Paul, MN 55116
Phone (651) 690-1311

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1245914530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163332",
            "telephone_number": "651-690-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "RESCH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "612-759-9298",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.