St. Peter Street Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31392 Issued in MN

Legal business name

ST. PETER STREET CLINIC

Practice address

514 Saint Peter St
250
Saint Paul, MN 55102-1001

Phone

(651) 645-9600

Fax

(651) 888-2944

NPI assigned

Jul 14, 2014

Last updated

Nov 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elisabeth A. Slattery, M.D.

Title

Owner/President

Phone

(651) 645-9600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1396152211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 SAINT PETER ST",
            "address_2": "250",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021001",
            "telephone_number": "651-645-9600",
            "fax_number": "651-888-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 SAINT PETER ST",
            "address_2": "250",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021001",
            "telephone_number": "651-645-9600",
            "fax_number": "651-888-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETER STREET CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "651-645-9600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "31392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Internal Medicine Physician in Minnesota

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