Ilbnc, P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

24C0001052 Issued in MN

Legal business name

ILBNC, P.A.

Doing business as

Institute for Low Back & Neck Care

Practice address

15700 37TH Ave N
Suite 210
Plymouth, MN 55446-3399

Phone

(952) 814-6600

NPI assigned

Jun 27, 2006

Last updated

Jan 7, 2015By 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

Patrick Wilfred Justin, R.N.

Title

Director of Surgery Center

Phone

(952) 814-6600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Institute for Low Back & Neck Care Doing business as

Locations

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1447287370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 METRO DR",
            "address_2": "SUITE 330",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254506",
            "telephone_number": "952-814-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 37TH AVE N",
            "address_2": "SUITE 210",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463399",
            "telephone_number": "952-814-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILBNC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "JUSTIN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "WILFRED",
        "authorized_official_title_or_position": "DIRECTOR OF SURGERY CENTER",
        "authorized_official_telephone_number": "952-814-6600",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "24C0001052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310032400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Institute for Low Back & Neck Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ilbnc, P.a. (Institute for Low Back & Neck Care)
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• Jesse Inderlee, LADC
• Infinite Health Collaborative, PA
• Infinite Health Collaborative, PA
• Ingress Healthcare Inc

• Clinic/Center in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.