Organization Active NPI

Hennepin County

Doing business as Branch III - Adult Opportunity Center

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
National Provider Identifier
1528539624
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HENNEPIN COUNTY
Doing business as
Branch III - Adult Opportunity Center
Practice address
740 East 17TH Street
Minneapolis, MN 55404-1601
Phone
(612) 348-5553
Fax
(612) 677-6299
NPI assigned
Dec 16, 2018
Last updated
Dec 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Stephanie Abel
Title
Area Manager
Phone
(612) 348-8824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

740 East 17TH Street
Minneapolis, MN 55404-1601

Mailing address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 348-5553

Other names 1

  • Branch III - Adult Opportunity Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218001012 MN Part B Supplier - Clinic/Group Practice 7911892849 Receives reassigned benefits from 194 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minneapolis, MN

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

740 E 17th St
Minneapolis, MN 55404
Phone (321) 400-7531

Practitioners & affiliated clinicians

Practitioners 3

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": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1528539624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 EAST 17TH STREET",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041601",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNEPIN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "ABEL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "AREA MANAGER",
        "authorized_official_telephone_number": "612-348-8824"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Branch III - Adult Opportunity Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Branch III - Adult Opportunity Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.