Integra Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

338318 Issued in MN

Legal business name

INTEGRA HOME CARE, INC.

Practice address

17645 Juniper Path Ste 115
Lakeville, MN 55044-7490

Phone

(952) 985-0672

Fax

(952) 985-0675

NPI assigned

Jan 19, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Dimitriy Papkov, RN

Title

President

Phone

(952) 985-0672

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1200700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1710163852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17645 JUNIPER PATH STE 115",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447490",
            "telephone_number": "952-985-0672",
            "fax_number": "952-985-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17645 JUNIPER PATH STE 115",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447490",
            "telephone_number": "952-985-0672",
            "fax_number": "952-985-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-19",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "PAPKOV",
        "authorized_official_first_name": "DIMITRIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-985-0672",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "338318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS A LICENCE",
            "identifier": "338318",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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