NPIMap

Organization Active NPI

Executive Health Care

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1295917995
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EXECUTIVE HEALTH CARE
Practice address
920 E 28TH Street
Suite 740
Minneapolis, MN 55407-1163
Phone
(612) 871-6268
Fax
(612) 870-1666
NPI assigned
Dec 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dudley Maurice McLinn, MDNPI 1659464451
Title
President
Phone
(612) 870-6268

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

920 E 28TH Street
Suite 740
Minneapolis, MN 55407-1163

Mailing address

920 E 28TH Street
Suite 740
Minneapolis, MN 55407-1163
Phone (612) 871-6268

National Provider Directory

National Provider Directory

Locations

920 E 28th St
Ste 740
Minneapolis, MN 55407
Phone (612) 870-7711

Practitioners & affiliated clinicians

Practitioners 4

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": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1295917995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 28TH STREET",
            "address_2": "SUITE 740",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071163",
            "telephone_number": "612-871-6268",
            "fax_number": "612-870-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 28TH STREET",
            "address_2": "SUITE 740",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071163",
            "telephone_number": "612-871-6268",
            "fax_number": "612-870-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "MCLINN",
        "authorized_official_first_name": "DUDLEY",
        "authorized_official_middle_name": "MAURICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-870-6268",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.