NPIMap

Organization Active NPI

Primary Care & Rehabilitation Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • St Louis Park, MN
National Provider Identifier
1306842547
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PRIMARY CARE & REHABILITATION CLINICS, INC.
Practice address
3015 Utah Ave S
St Louis Park, MN 55426-3671
Phone
(952) 933-8900
Fax
(952) 945-9536
NPI assigned
Jun 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Leon B Frid, D.C.NPI 1639117559
Title
President
Phone
(952) 933-8900

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
Multi-Specialty Clinic/Center 261QM1300X MN Primary

Addresses

Primary practice location

3015 Utah Ave S
St Louis Park, MN 55426-3671

Mailing address

3015 Utah Ave S
St Louis Park, MN 55426-3671
Phone (952) 933-8900

Other identifiers 3

IdentifierTypeStateIssuer
3C060TEOtherMNBCBS D.C. PROV #
2M391TEOtherMNBCBS MD PROVIDER #
8B610TEOtherMNBCBS PT PROVIDER #

National Provider Directory

National Provider Directory

Locations

7108 Chicago Ave
Richfield, MN 55423
Phone (612) 353-5036

3015 Utah Ave S
St Louis Park, MN 55426
Phone (952) 933-8900

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306842547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 UTAH AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263671",
            "telephone_number": "952-933-8900",
            "fax_number": "952-945-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 UTAH AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263671",
            "telephone_number": "952-933-8900",
            "fax_number": "952-945-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE & REHABILITATION CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRID",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-933-8900",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS D.C. PROV #",
            "identifier": "3C060TE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD PROVIDER #",
            "identifier": "2M391TE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PT PROVIDER #",
            "identifier": "8B610TE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.