Organization Active NPI

Realief Medical P.a.

  • Multi-Specialty Clinic/Center
  • St Louis Park, MN
National Provider Identifier
1508102500
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
24538 Issued in MN
Legal business name
REALIEF MEDICAL P.A.
Practice address
1660 Highway 100 S
Suite 229
St Louis Park, MN 55416-1529
Phone
(952) 456-6160
Fax
(952) 456-6184
NPI assigned
Dec 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Jessica Haley
Title
Operations Manager
Phone
(952) 456-6160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 24538 MN Primary

Addresses

Primary practice location

1660 Highway 100 S
Suite 229
St Louis Park, MN 55416-1529

Mailing address

1660 Highway 100 S
Suite 229
St Louis Park, MN 55416-1529
Phone (952) 456-6160

Other identifiers 1

IdentifierTypeStateIssuer
C09271OtherMNMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1660 Highway 100 S
Ste 229
St Louis Park, MN 55416
Phone (952) 456-6160

Practitioners & affiliated clinicians

Practitioners 1

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": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1508102500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S",
            "address_2": "SUITE 229",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161529",
            "telephone_number": "952-456-6160",
            "fax_number": "952-456-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S",
            "address_2": "SUITE 229",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161529",
            "telephone_number": "952-456-6160",
            "fax_number": "952-456-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIEF MEDICAL P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "952-456-6160"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": "24538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C09271",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.