Active NPI
Crown Medical Support Services Inc
Doing business as Crown Medical 245G Program
- Primary Care Clinic/Center
- Minneapolis, MN
National Provider Identifier
1598451239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- CROWN MEDICAL SUPPORT SERVICES INC
- Doing business as
- Crown Medical 245G Program
- Practice address
- 1925 1St Ave S
Minneapolis, MN 55403-3724 - Phone
- (612) 978-3783
- Fax
- (612) 354-7719
- NPI assigned
- Apr 14, 2023
- Last updated
- Feb 26, 2024
- Organization subpart
- Yes
- Parent organization
- 1730546672
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Chike Orizu Onyekaba
- Title
- Programs Coordinator
- Phone
- (612) 871-4354
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
1925 1St Ave S
Minneapolis, MN 55403-3724
Mailing address
1925 1St Ave S
Minneapolis, MN 55403-3724
Phone (612) 978-3783
Other names 1
- Crown Medical 245G Program
National Provider Directory
National Provider Directory- Part of
- Crown Medical Support Services Inc
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1720045271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708905600000",
"number": "1598451239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 1ST AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033724",
"telephone_number": "612-978-3783",
"fax_number": "612-354-7719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 1ST AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033724",
"telephone_number": "612-978-3783",
"fax_number": "612-354-7719"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CROWN MEDICAL SUPPORT SERVICES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "1730546672",
"enumeration_date": "2023-04-14",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A",
"authorized_official_last_name": "ONYEKABA",
"authorized_official_first_name": "CHIKE",
"authorized_official_middle_name": "ORIZU",
"authorized_official_title_or_position": "PROGRAMS COORDINATOR",
"authorized_official_telephone_number": "612-871-4354",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Crown Medical 245G Program",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Crown Medical 245G Program",
"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 Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.