Central Medical Clinic LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

37899 Issued in MN

Legal business name

CENTRAL MEDICAL CLINIC LLC

Practice address

393 N Dunlap Street
Suite LL34
St Paul, MN 55104

Phone

(651) 644-6002

Fax

(651) 644-2048

NPI assigned

Jul 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Matthew J Swanson

Title

Paralegal

Phone

(612) 922-7573

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1437313434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 N DUNLAP STREET",
            "address_2": "SUITE LL34",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-644-6002",
            "fax_number": "651-644-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 N DUNLAP STREET",
            "address_2": "SUITE LL34",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-644-6002",
            "fax_number": "651-644-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARALEGAL",
        "authorized_official_telephone_number": "612-922-7573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MN",
            "license": "37899",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "37899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2168900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centerpoint Care Inc
• Centerpoint Care Inc
• Centerpointe Behavioral Health Minneapolis LLC
• Central Golden Care Services Inc.
• Central Internal Medicine Associates PA
• Central Medical Clinic PLLC
• Central Medical Clinic, PLLC.
• Central Medical Wellness & Regeneration
• Central Medical Wellness Inc
• Central Towers Limited Partnership

• Pain Medicine Physician in St Paul, MN
• Providers in St Paul, MN by specialty
• Pain Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.