Advacare Clinics,LTD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ADVACARE CLINICS,LTD

Practice address

5001 American Blvd W
Ste.945
Bloomington, MN 55437-1108

Phone

(952) 835-6653

Fax

(952) 835-3895

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Dennis John Lenselink

Title

Clinic Administrator

Phone

(952) 835-6653

Specialties & licenses 9

Addresses

Other identifiers 1

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1265614242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 AMERICAN BLVD W",
            "address_2": "STE.945",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371108",
            "telephone_number": "952-835-6653",
            "fax_number": "952-835-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 AMERICAN BLVD W",
            "address_2": "STE.945",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371108",
            "telephone_number": "952-835-6653",
            "fax_number": "952-835-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVACARE CLINICS,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "LENSELINK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "952-835-6653",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "401",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATION NUMBER PART A (CCN)",
            "identifier": "24-6608",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.