Minnesota Pain Prevention Clinic, P.a.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

MINNESOTA PAIN PREVENTION CLINIC, P.A.

Practice address

3475 Plymouth Blvd Ste 200
Minneapolis, MN 55447-1539

Phone

(612) 619-1678

NPI assigned

Jul 12, 2022

Last updated

Jul 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chris Taylor

Title

Administrator

Phone

(612) 296-4404

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1285368514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120114",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551120012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 PLYMOUTH BLVD STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554471539",
            "telephone_number": "612-619-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA PAIN PREVENTION CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-296-4404"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "AthenaHealth",
            "affiliation": "N",
            "endpointDescription": "AthenaHealth EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HL7",
            "address_1": "3475 Plymouth Blvd Ste 200",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554471539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pain Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pain Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.