Peace Out Pain PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PEACE OUT PAIN PLLC

Practice address

3420 W 29TH St
Minneapolis, MN 55416-4309

Phone

(419) 308-2644

NPI assigned

Oct 21, 2021

Last updated

Nov 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kavita Desai Dakoji, PHDNPI 1194093641

Title

Founder

Phone

(419) 308-2644

Specialties & licenses 1

Addresses

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.

• Kavita Desai Dakoji, PHD, LP

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1194093641
  NPD Authorized official

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1609539055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 W 29TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164309",
            "telephone_number": "419-308-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 W 29TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164309",
            "telephone_number": "419-308-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OUT PAIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "DAKOJI",
        "authorized_official_first_name": "KAVITA",
        "authorized_official_middle_name": "DESAI",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "419-308-2644",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Health Service Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.