NPIMap

Organization Active NPI

Recovery Partners, PC at Plymouth

  • Addiction (Substance Use Disorder) Psychologist
  • Plymouth, MN
National Provider Identifier
1376902999
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Legal business name
RECOVERY PARTNERS, PC AT PLYMOUTH
Practice address
11505 36TH Ave N
Plymouth, MN 55441-2304
Phone
(651) 213-4286
NPI assigned
Feb 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Dr. Marvin Seppala, MD
Title
Chief Medical Officer
Phone
(651) 213-4825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X Primary

Addresses

Primary practice location

11505 36TH Ave N
Plymouth, MN 55441-2304

Mailing address

11505 36TH Ave N
Plymouth, MN 55441-2304
Phone (651) 213-4286

National Provider Directory

National Provider Directory
Tax ID family
Recovery Partners PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1376902999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 36TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412304",
            "telephone_number": "651-213-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 36TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412304",
            "telephone_number": "651-213-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY PARTNERS, PC AT PLYMOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "SEPPALA",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "651-213-4825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.