Neisen Pain Clinic LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

NEISEN PAIN CLINIC LLC

Practice address

302 Brighton Ave S
Buffalo, MN 55313-2422

Phone

(763) 595-1411

Fax

(763) 595-1412

NPI assigned

Feb 24, 2016

Organization subpart

No

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

Authorized official

Name

Deanna Alama

Title

Administrator

Phone

(763) 595-1411

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1477913168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BRIGHTON AVE S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132422",
            "telephone_number": "763-595-1411",
            "fax_number": "763-595-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BRIGHTON AVE S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132422",
            "telephone_number": "763-595-1411",
            "fax_number": "763-595-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEISEN PAIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "ALAMA",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-595-1411"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Morris
• Brian Moselle
• Robert Thomas Mullaney, M.D.
• Michelle Ann Mulligan
• Kendall Murray, P.T.
• Erin Elizabeth Nelson, NP-C
• Malinda Mary Nelson
• Michael Brent Nelson, D.O.
• Jesse Nemgar
• Neve Inc (Avada Audiology & Hearing Care)

• Multi-Specialty Clinic/Center in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Multi-Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.