Valhalla Place Clinic, P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VALHALLA PLACE CLINIC, P.A.

Practice address

6043 Hudson Rd Ste 220
Woodbury, MN 55125-1033

Phone

(651) 925-8200

Fax

(652) 925-8201

NPI assigned

Jan 28, 2015

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jay Higham

Title

Ceo

Phone

(214) 365-6112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1780074849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251033",
            "telephone_number": "651-925-8200",
            "fax_number": "652-925-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251033",
            "telephone_number": "651-925-8200",
            "fax_number": "652-925-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALHALLA PLACE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.