NPIMap

Organization Active NPI

Total Healthcare and Physical Medicine PLLC.

  • General Practice Physician
  • Roseville, MN
National Provider Identifier
1629373246
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
30851 Issued in MN
Legal business name
TOTAL HEALTHCARE AND PHYSICAL MEDICINE PLLC.
Practice address
2151 Hamline Ave N
Ste. 111
Roseville, MN 55113-4236
Phone
(651) 636-5560
Fax
(651) 636-4406
NPI assigned
Jan 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Ms. Koula Vang
Title
Office Manager
Phone
(651) 636-5560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 30851 MN Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 13954 MN

Addresses

Primary practice location

2151 Hamline Ave N
Ste. 111
Roseville, MN 55113-4236

Mailing address

2151 Hamline Ave N
Ste. 111
Roseville, MN 55113-4236
Phone (651) 636-5560

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1629373246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 HAMLINE AVE N",
            "address_2": "STE. 111",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134236",
            "telephone_number": "651-636-5560",
            "fax_number": "651-636-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 HAMLINE AVE N",
            "address_2": "STE. 111",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134236",
            "telephone_number": "651-636-5560",
            "fax_number": "651-636-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL HEALTHCARE AND PHYSICAL MEDICINE PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "VANG",
        "authorized_official_first_name": "KOULA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-636-5560",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MN",
            "license": "30851",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "13954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.