Organization Active NPI

Neurology Specialists, LLC

  • Neurology Physician
  • St Louis Park, MN
National Provider Identifier
1659494961
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
36061 Issued in MN
Legal business name
NEUROLOGY SPECIALISTS, LLC
Practice address
4500 Park Glen Road
Suite 160
Saint Louis Park, MN 55416-4888
Phone
(952) 767-7771
Fax
(952) 767-7774
NPI assigned
Apr 10, 2007
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Mrs. Katie L Witschen
Title
Office Manager
Phone
(952) 767-7771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 36061 MN Primary

Addresses

Primary practice location

4500 Park Glen Road
Suite 160
Saint Louis Park, MN 55416-4888

Mailing address

4500 Park Glen Road
Suite 160
Saint Louis Park, MN 55416-4888
Phone (952) 767-7771

National Provider Directory

National Provider Directory

Locations

625 E Nicollet Blvd
Ste 325
Burnsville, MN 55337
Phone (763) 377-9222

514 Saint Peter St
Ste 280
Saint Paul, MN 55102
Phone (651) 291-2551

4500 Park Glen Rd
Ste 160
St Louis Park, MN 55416
Phone (952) 767-7771

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.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1659494961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN ROAD",
            "address_2": "SUITE 160",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554164888",
            "telephone_number": "952-767-7771",
            "fax_number": "952-767-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN ROAD",
            "address_2": "SUITE 160",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554164888",
            "telephone_number": "952-767-7771",
            "fax_number": "952-767-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "WITSCHEN",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-767-7771",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "36061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.