NPIMap

Organization Active NPI

PPSM

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1467829168
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17773 Issued in MN
Legal business name
PPSM
Practice address
1061 Grand Ave
Saint Paul, MN 55105-3002
Phone
(651) 212-4920
NPI assigned
Aug 28, 2015
Last updated
Aug 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Authorized official

Name
Nicole UzendoskiNPI 1336280619
Title
Licsw
Phone
(612) 644-0415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17773 MN Primary

Addresses

Primary practice location

1061 Grand Ave
Saint Paul, MN 55105-3002

Mailing address

1061 Grand Ave
Saint Paul, MN 55105-3002
Phone (651) 212-4920

National Provider Directory

National Provider Directory
Tax ID family
PPSM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1467829168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002",
            "telephone_number": "651-212-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002",
            "telephone_number": "651-212-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPSM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "UZENDOSKI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "LICSW",
        "authorized_official_telephone_number": "612-644-0415"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 28, 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.