NPIMap

Organization Active NPI

Medexpress Urgent Care Minnesota P.C.

Doing business as MedExpress Urgent Care - Eden Prairie, W 78th St

  • Urgent Care Clinic/Center
  • Eden Prairie, MN
National Provider Identifier
1588025332
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDEXPRESS URGENT CARE MINNESOTA P.C.
Doing business as
MedExpress Urgent Care - Eden Prairie, W 78th St
Practice address
16490 W 78TH St
Eden Prairie, MN 55346-4300
Phone
(952) 934-5332
Fax
(952) 934-2647
NPI assigned
Mar 8, 2016
Last updated
Nov 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Tim Bugin
Title
VP Payor Contracting
Phone
(304) 225-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
Emergency Medicine Physician 207P00000X NU

Addresses

Primary practice location

16490 W 78TH St
Eden Prairie, MN 55346-4300

Mailing address

1001 Consol Energy Dr
Canonsburg, PA 15317-6506
Phone (304) 225-2500

Other identifiers 1

IdentifierTypeStateIssuer
1588025332MedicaidMN

Other names 1

  • MedExpress Urgent Care - Eden Prairie, W 78th St Doing business as

National Provider Directory

National Provider Directory

Locations

16490 W 78th St
Eden Prairie, MN 55346
Phone (952) 934-5332

Practitioners & affiliated clinicians

Practitioners 112

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.

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1588025332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CONSOL ENERGY DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153176506",
            "telephone_number": "304-225-2500",
            "fax_number": "724-743-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16490 W 78TH ST",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553464300",
            "telephone_number": "952-934-5332",
            "fax_number": "952-934-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE MINNESOTA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "BUGIN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "VP PAYOR CONTRACTING",
        "authorized_official_telephone_number": "304-225-2500"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588025332",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Eden Prairie, W 78th St",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.