NPIMap

Organization Active NPI

Ace Medical Center, LLC

  • Primary Care Clinic/Center
  • Eden Prairie, MN
National Provider Identifier
1740798008
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ACE MEDICAL CENTER, LLC
Practice address
10259 Englewood Dr
Eden Prairie, MN 55347-4623
Phone
(617) 413-4952
NPI assigned
Jan 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Authorized official

Name
Regine W Ndifor, CNP RN
Title
Administrator
Phone
(617) 413-4952

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Community Health Clinic/Center 261QC1500X
Federal Public Health Clinic/Center 261QP0904X
Primary Care Clinic/Center 261QP2300X Primary
Primary Care Clinic/Center 261QP2300X 3233 MN
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

10259 Englewood Dr
Eden Prairie, MN 55347-4623

Mailing address

PO Box 44044
Eden Prairie, MN 55344-1044
Phone (617) 413-4952

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1740798008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44044",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553441044",
            "telephone_number": "617-413-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10259 ENGLEWOOD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474623",
            "telephone_number": "617-413-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "NDIFOR",
        "authorized_official_first_name": "REGINE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-413-4952",
        "authorized_official_credential": "CNP RN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": "3233",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.