MN Wellness

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MN WELLNESS

Practice address

1900 County Road D E Ste 100
Maplewood, MN 55109-4570

Phone

(612) 423-8330

NPI assigned

Jan 6, 2021

Organization subpart

No

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

Authorized official

Name

Stephanie Sill, BSDH

Title

Lab Director

Phone

(763) 670-2493

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1568050342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 170TH LN NE",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553045252",
            "telephone_number": "763-670-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COUNTY ROAD D E STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551094570",
            "telephone_number": "612-423-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MN WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "SILL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "763-670-2493",
        "authorized_official_credential": "BSDH"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mn-wellness.com",
            "affiliation": "N",
            "endpointDescription": "web",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1900 County Road D E Ste 100",
            "city": "Maplewood",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551094570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.