NPIMap

Organization Active NPI

Minnesota Natural Medicine

  • General Practice Physician
  • Vadnais Heights, MN
National Provider Identifier
1376996132
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1061 Issued in MN
Legal business name
MINNESOTA NATURAL MEDICINE
Practice address
3485 Willow Lake Blvd
#100
Vadnais Heights, MN 55110-5152
Phone
(651) 484-5567
NPI assigned
Jul 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Authorized official

Name
Jonathan Otten, N.D.
Title
Physician
Phone
(651) 484-5567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 1061 MN Primary

Addresses

Primary practice location

3485 Willow Lake Blvd
#100
Vadnais Heights, MN 55110-5152

Mailing address

3485 Willow Lake Blvd
#100
Vadnais Heights, MN 55110-5152

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Natural Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17227/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1376996132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 WILLOW LAKE BLVD",
            "address_2": "#100",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 WILLOW LAKE BLVD",
            "address_2": "#100",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105152",
            "telephone_number": "651-484-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA NATURAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "OTTEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "651-484-5567",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MN",
            "license": "1061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.