Individual provider Active NPI

Luther Terrence Prince, MD

  • Physical Medicine & Rehabilitation Physician
  • Minneapolis, MN
National Provider Identifier
1730262486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
37672 Issued in MN
Practice address
One Veteran'S Drive
Veteran Affairs Medical Center
Minneapolis, MN 55417
Phone
(612) 467-5987
Fax
(612) 725-2142
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 37672 MN Primary

Addresses

Primary practice location

One Veteran'S Drive
Veteran Affairs Medical Center
Minneapolis, MN 55417

Mailing address

One Veteran'S Drive
Veteran Affairs Medical Center
Minneapolis, MN 55417
Phone (612) 467-5987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37672MNMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730262486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VETERAN'S DRIVE",
            "address_2": "VETERAN AFFAIRS MEDICAL CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-467-5987",
            "fax_number": "612-725-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE VETERAN'S DRIVE",
            "address_2": "VETERAN AFFAIRS MEDICAL CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55417",
            "telephone_number": "612-467-5987",
            "fax_number": "612-725-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "LUTHER",
        "middle_name": "TERRENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "37672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.