NPIMap

Organization Active NPI

Aris Clinic PA

Doing business as Aris Clinic

  • Psychiatry Physician
  • Woodbury, MN
National Provider Identifier
1609978063
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ARIS CLINIC PA
Doing business as
Aris Clinic
Practice address
2040 Woodwinds Dr
Woodbury, MN 55125-2522
Phone
(651) 259-9750
Fax
(651) 259-9790
NPI assigned
Sep 5, 2006
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Molly Wilson
Title
General Manager
Phone
(651) 259-9750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2040 Woodwinds Dr
Woodbury, MN 55125-2522

Mailing address

2040 Woodwinds Dr
Woodbury, MN 55125-2522
Phone (651) 259-9750

Other practice location 1

2675 Long Lake Rd Ste 125
Roseville, MN 55113-2823
Phone (651) 259-9750

Other practice location 2

151 W Burnsville Pkwy Ste 100
Burnsville, MN 55337-2525
Phone (651) 259-9750

Other names 2

  • Aris Clinic Doing business as
  • Raymond Kennedy MD PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050511000965 MN Part B Supplier - Clinic/Group Practice 0244270973 Receives reassigned benefits from 10 practitioners
Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Locations

7616 Currell Blvd
Ste 100
Woodbury, MN 55125
Phone (651) 259-9700

7616 Currell Blvd
Ste 275
Woodbury, MN 55125
Phone (651) 264-0260

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1609978063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750",
            "fax_number": "651-259-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252522",
            "telephone_number": "651-259-9750",
            "fax_number": "651-259-9790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2675 Long Lake Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551132823",
            "country_code": "US",
            "telephone_number": "651-259-9750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 W Burnsville Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553372525",
            "country_code": "US",
            "telephone_number": "651-259-9750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARIS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "651-259-9750"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aris Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aris Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Raymond Kennedy MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.