NPIMap

Organization Active NPI

Twin Cities Occupational Health and Rehabilitation

  • Occupational Medicine Clinic/Center
  • Blaine, MN
National Provider Identifier
1770780876
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
30816 Issued in MN
Legal business name
TWIN CITIES OCCUPATIONAL HEALTH AND REHABILITATION
Practice address
10190 Baltimore Street North East
Suite 100
Blaine, MN 55449
Phone
(763) 780-8264
Fax
(763) 780-8274
NPI assigned
Jul 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Janice K Raverty
Title
Clinic Administrator
Phone
(651) 224-8264

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X 30816 MN Primary
Occupational Medicine Clinic/Center 261QX0100X 42667 MN

Addresses

Primary practice location

10190 Baltimore Street North East
Suite 100
Blaine, MN 55449

Mailing address

10190 Baltimore Street North East
Suite 100
Blaine, MN 55449
Phone (763) 780-8264

Other identifiers 2

IdentifierTypeStateIssuer
30816OtherMNMEDICAL LICENSE
42667OtherMNMEDICAL LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Twin Cities Occupational Health and Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1770780876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10190 BALTIMORE STREET NORTH EAST",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-780-8264",
            "fax_number": "763-780-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10190 BALTIMORE STREET NORTH EAST",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "763-780-8264",
            "fax_number": "763-780-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES OCCUPATIONAL HEALTH AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "RAVERTY",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "651-224-8264"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MN",
            "license": "30816",
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MN",
            "license": "42667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "30816",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "42667",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.