Optage Primary Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

OPTAGE PRIMARY CARE, LLC

Practice address

2845 Hamline Ave N
Roseville, MN 55113-7127

Phone

(651) 631-6100

Fax

(651) 631-6343

NPI assigned

Feb 17, 2011

Organization subpart

No

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

Authorized official

Name

Sharon Klefsaas

Title

Executive Director of Operations

Phone

(651) 631-6145

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Optage Inc

  • Rehabilitation Clinic/Center
  • Andover, MN
  • NPI 1881383446

  Member Of

  NPD member

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1760789259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137127",
            "telephone_number": "651-631-6100",
            "fax_number": "651-631-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 HAMLINE AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551137127",
            "telephone_number": "651-631-6100",
            "fax_number": "651-631-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTAGE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "KLEFSAAS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "651-631-6145"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nura Abdi Omer
• Omnipotent Youth Society L.L.C.
• Onefamily Therapy & Wellness Center LLC
• Rachael Marie Opseth
• Optage Inc
• Option Care Enterprises, Inc.
• Option Care Enterprises, Inc.
• Optometric Services, LLC
• Optum Infusion Services 500, Inc.
• Samantha Oren, LGSW

• Primary Care Clinic/Center in Roseville, MN
• Providers in Roseville, MN by specialty
• Primary Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.