Impact Physical Medicine of St. Paul

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

IMPACT PHYSICAL MEDICINE OF ST. PAUL

Practice address

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

Phone

(651) 592-9402

Fax

(651) 641-0726

NPI assigned

Jan 7, 2020

Organization subpart

No

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

Authorized official

Name

Stan Babel

Title

Ceo

Phone

(651) 592-9402

Specialties & licenses 1

Addresses

Other names 1

• Impact Physical Medicine Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1487294401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W STE 10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-592-9402",
            "fax_number": "651-641-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W STE 10",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043898",
            "telephone_number": "651-592-9402",
            "fax_number": "651-641-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL MEDICINE OF ST. PAUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "BABEL",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-592-9402"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@impactpm.com",
            "affiliation": "N",
            "endpointDescription": "secure e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct secure e-mail",
            "address_1": "1600 University Ave W Ste 10",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551043898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Impact Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Medicine & Rehabilitation Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.