Active NPI
Minnesota Wound Care LLC
- General Practice Physician
- Minneapolis, MN
National Provider Identifier
1760141980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- MINNESOTA WOUND CARE LLC
- Practice address
- 3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761 - Phone
- (763) 587-7737
- Fax
- (763) 587-7069
- NPI assigned
- Dec 15, 2021
- Organization subpart
- Yes
- Parent organization
- GERIATRIC SERVICES OF MINNESOTA, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Tufano
- Title
- Ceo and Treasurer
- Phone
- (469) 231-1545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Mailing address
3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7823459 | Medicaid | MN |
Other names 1
- Genevive
National Provider Directory
National Provider Directory- Part of
- Geriatric Services of
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Geriatric Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1093131419
Member Of
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Geriatric Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1093131419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1639526400000",
"number": "1760141980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3433 BROADWAY ST NE STE 300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554131761",
"telephone_number": "763-587-7737",
"fax_number": "763-587-7069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3433 BROADWAY ST NE STE 300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554131761",
"telephone_number": "763-587-7737",
"fax_number": "763-587-7069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINNESOTA WOUND CARE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GERIATRIC SERVICES OF MINNESOTA, LLC",
"enumeration_date": "2021-12-15",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A",
"authorized_official_last_name": "TUFANO",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "CEO AND TREASURER",
"authorized_official_telephone_number": "469-231-1545"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7823459",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Genevive",
"code": "3",
"type": "Doing Business As"
}
]
}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 Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.