Active NPI
Neil Laitala
- Home Modifications Contractor
- Milaca, MN
National Provider Identifier
1265978985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- BC270850
- Practice address
- 5755 152ND St # BT
Milaca, MN 56353-3975 - Phone
- (763) 244-0761
- NPI assigned
- Jan 19, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | BC270850 | MN | Primary |
Addresses
Primary practice location
5755 152ND St # BT
Milaca, MN 56353-3975
Mailing address
5755 152ND St # BT
Milaca, MN 56353-3975
Phone (763) 244-0761
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BC270850 | MN | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1265978985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5755 152ND ST # BT",
"city": "MILACA",
"state": "MN",
"postal_code": "563533975",
"telephone_number": "763-244-0761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5755 152ND ST # BT",
"city": "MILACA",
"state": "MN",
"postal_code": "563533975",
"telephone_number": "763-244-0761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAITALA",
"first_name": "NEIL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "MN",
"license": "BC270850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milaca, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.