NPIMap

Organization Active NPI

Impact Physical Medicine and Aquatic Center

  • Physical Therapy Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1457417131
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
IMPACT PHYSICAL MEDICINE AND AQUATIC CENTER
Practice address
1600 University Ave W
Suite 10
Saint Paul, MN 55104-3898
Phone
(651) 646-7246
Fax
(651) 641-0726
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Authorized official

Name
Mr. Stanley Babel
Title
Ceo
Phone
(651) 999-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1600 University Ave W
Suite 10
Saint Paul, MN 55104-3898

Mailing address

1600 University Ave W
Suite 10
Saint Paul, MN 55104-3898
Phone (651) 646-7246

Other names 1

  • IMPACT Physical Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

1600 University Ave W
Ste 10A
Saint Paul, MN 55104
Phone (651) 641-0688

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1457417131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "SUITE 10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-646-7246",
            "fax_number": "651-641-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W",
            "address_2": "SUITE 10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-646-7246",
            "fax_number": "651-641-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL MEDICINE AND AQUATIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "BABEL",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-999-1030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMPACT Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.