NPIMap

Organization Active NPI

Integrated Care Service

  • Early Intervention Provider Agency
  • Elk River, MN
National Provider Identifier
1275214355
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
INTEGRATED CARE SERVICE
Practice address
12254 67TH St NE
Elk River, MN 55330-6900
Phone
(612) 986-4514
NPI assigned
Jul 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Doris OribamiseNPI 1114793726
Title
Ceo
Phone
(612) 986-4514

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
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

12254 67TH St NE
Elk River, MN 55330-6900

Mailing address

12254 67TH St NE
Elk River, MN 55330-6900

National Provider Directory

National Provider Directory

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": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1275214355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12254 67TH ST NE",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553306900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12254 67TH ST NE",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553306900",
            "telephone_number": "612-986-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CARE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "ORIBAMISE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-986-4514"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.