NPIMap

Organization Active NPI

David L. Gilbertson, DO, PA

  • Primary Care Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1265547533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
6251520 Issued in MN
Legal business name
DAVID L. GILBERTSON, DO, PA
Practice address
2315 Como Ave
Saint Paul, MN 55108-1723
Phone
(651) 646-2549
Fax
(651) 646-2480
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Lee Gilbertson, DONPI 1962516575
Title
President
Phone
(651) 646-2549

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 6251520 MN Primary

Addresses

Primary practice location

2315 Como Ave
Saint Paul, MN 55108-1723

Mailing address

2315 Como Ave
Saint Paul, MN 55108-1723
Phone (651) 646-2549

Other identifiers 1

IdentifierTypeStateIssuer
25Y48ANOtherMNBLUECROSS BLUESHIELD

Other names 1

  • ST ANTHONY PARK CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

2315 Como Ave
Saint Paul, MN 55108
Phone (651) 646-2549

Practitioners & affiliated clinicians

Practitioners 2

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265547533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081723",
            "telephone_number": "651-646-2549",
            "fax_number": "651-646-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081723",
            "telephone_number": "651-646-2549",
            "fax_number": "651-646-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. GILBERTSON, DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-646-2549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": "6251520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "25Y48AN",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ANTHONY PARK CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.