Epicenterphd Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

380825 Issued in MN

Legal business name

EPICENTERPHD INC

Practice address

8899 Deer Valley Rd
Pine City, MN 55063-4424

Phone

(612) 203-2473

Fax

(612) 460-9804

NPI assigned

Mar 22, 2017

Last updated

Mar 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Walter Martini

Title

Ceo

Phone

(612) 203-2473

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1255862280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8899 DEER VALLEY RD",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550634424",
            "telephone_number": "612-203-2473",
            "fax_number": "612-460-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8899 DEER VALLEY RD",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550634424",
            "telephone_number": "612-203-2473",
            "fax_number": "612-460-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPICENTERPHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "MARTINI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-203-2473",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225XH1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Human Factors",
            "state": "MN",
            "license": "380825",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MN",
            "license": "380825",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "380825",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MN",
            "license": "380825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.