Active NPI
Alan Quenton Radke, M.D.
- Psychiatry Physician
- Saint Paul, MN
National Provider Identifier
1588742563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 30756
- Practice address
- 444 Lafayette Rd N
Saint Paul, MN 55155-3802 - Phone
- (651) 431-3684
- Fax
- (651) 431-7505
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 30756 | MN | Primary |
Addresses
Primary practice location
444 Lafayette Rd N
Saint Paul, MN 55155-3802
Mailing address
PO Box 64979
Saint Paul, MN 55164-0979
Phone (651) 431-3684
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30756 | MN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588742563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64979",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551640979",
"telephone_number": "651-431-3684",
"fax_number": "651-431-7505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 LAFAYETTE RD N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551553802",
"telephone_number": "651-431-3684",
"fax_number": "651-431-7505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADKE",
"first_name": "ALAN",
"middle_name": "QUENTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "30756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.