Northern OB GYN Associates PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

NORTHERN OB GYN ASSOCIATES PC

Practice address

3875 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2518

Phone

(763) 427-8500

Fax

(763) 427-8505

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. John Philip Wust III, M.D.NPI 1366443707

Title

President

Phone

(763) 427-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northern Ob/Gyn Associates Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Philip Wust III, MD

  • Obstetrics & Gynecology Physician
  • Blaine, MN
  • NPI 1366443707
  NPD (past) Authorized official

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1275534612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SDS 12 2503",
            "address_2": "PO BOX 86",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554862503",
            "telephone_number": "763-427-8500",
            "fax_number": "763-427-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332518",
            "telephone_number": "763-427-8500",
            "fax_number": "763-427-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN OB GYN ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "WUST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-427-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987940000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Ob/Gyn Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.