Intrepid of the Twin Cities Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

325703 Issued in MN

Legal business name

INTREPID OF THE TWIN CITIES INC

Practice address

3433 Broadway St NE Ste 240a
Minneapolis, MN 55413-1740

Phone

(651) 638-7800

Fax

(651) 638-7801

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

John Kunysz Jr.

Title

Ceo/President

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1659353233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 240A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131740",
            "telephone_number": "651-638-7800",
            "fax_number": "651-638-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID OF THE TWIN CITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "KUNYSZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "325703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233994300",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.