NPIMap

Organization Active NPI

Advanced Injury Rehabilitation, LTD.

  • Clinic/Center
  • Roseville, MN
National Provider Identifier
1376633511
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ADVANCED INJURY REHABILITATION, LTD.
Practice address
1752 Lexington Ave N
Roseville, MN 55113-6516
Phone
(651) 487-5950
Fax
(651) 487-6016
NPI assigned
Oct 16, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Frederick Ashley Clary, D.C.NPI 1336101674
Title
Owner
Phone
(651) 487-5950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1752 Lexington Ave N
Roseville, MN 55113-6516

Mailing address

1752 Lexington Ave N
Roseville, MN 55113-6516
Phone (651) 487-5950

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376633511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 LEXINGTON AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136516",
            "telephone_number": "651-487-5950",
            "fax_number": "651-487-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 LEXINGTON AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136516",
            "telephone_number": "651-487-5950",
            "fax_number": "651-487-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INJURY REHABILITATION, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLARY",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-487-5950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.