G2 Enterprises, Inc

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

G2 ENTERPRISES, INC

Practice address

5812 Excelsior Blvd
St Louis Park, MN 55416-2830

Phone

(952) 992-2420

Fax

(952) 922-2400

NPI assigned

May 28, 2021

Organization subpart

No

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

Authorized official

Name

Greg Mark Gray, MBA, CPA

Title

President

Phone

(952) 992-2420

Specialties & licenses 1

Addresses

Other names 1

• Active Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1760058937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162830",
            "telephone_number": "952-992-2420",
            "fax_number": "952-922-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162830",
            "telephone_number": "952-992-2420",
            "fax_number": "952-922-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G2 ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-992-2420",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edwin H Funk
• Laura Michelle Furda-Raine, M.D.
• Timothy Furland, PT, DPT
• Sakeena Alia Futrell-Carter, APRN, CNM, CNP
• Aimee Futrell, D.P.T.
• Timothy Aaron Gabrielsen, MD
• Isabelle J Gaetz
• Liat Rose Gafni Lachter, OTD
• Robin Gager
• Victoria Gagnon, LICSW

• Point of Service in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Point of Service in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.