Community Care Clinics of Minnesota

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

COMMUNITY CARE CLINICS OF MINNESOTA

Practice address

2015 Chicago Ave
Minneapolis, MN 55404-2813

Phone

(952) 228-0420

Fax

(612) 345-4191

NPI assigned

Aug 21, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robert Larbi-Odam

Title

Chief Executive Officer

Phone

(952) 228-0420

Specialties & licenses 2

Addresses

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Community Care Clinics of Minnesota

  • Non-emergency Medical Transport (VAN)
  • Sauk Rapids, MN
  • NPI 1053895235
  NPPES parent name
• Community Care Clinics of Minnesota - Mhi Building Office

  • Clinic/Center
  • Sauk Rapids, MN
  • NPI 1366915878
  NPPES parent name

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1417438169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042813",
            "telephone_number": "952-228-0420",
            "fax_number": "612-345-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042813",
            "telephone_number": "952-228-0420",
            "fax_number": "612-345-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CLINICS OF MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "LARBI-ODAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "952-228-0420",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer McAuley Comfort, MD
• Amy Commers, PHARM D
• Comminity Choice Transportation LLC
• Community Autism Therapy Center LLC
• Community Boarding Care
• Community Care Partners
• Community Development Center LLC
• Community Development Resource Center
• Community Development Services LLC
• Community Emergency Service Meals on Wheels

• Primary Care Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.