NPIMap

Organization Active NPI

Wellness Early Development

  • Early Intervention Provider Agency
  • Bloomington, MN
National Provider Identifier
1811769953
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
WELLNESS EARLY DEVELOPMENT
Practice address
2748 E 82ND St
Bloomington, MN 55425-1365
Phone
(612) 505-3700
Fax
(952) 600-4013
NPI assigned
Oct 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Ubah Isse MohamudNPI 1831823582
Title
Ceo
Phone
(651) 322-0152

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

2748 E 82ND St
Bloomington, MN 55425-1365

Mailing address

2748 E 82ND St
Bloomington, MN 55425-1365
Phone (612) 505-3700

National Provider Directory

National Provider Directory

Locations

2748 E 82nd St
Bloomington, MN 55425
Phone (651) 322-0152

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1811769953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 E 82ND ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251365",
            "telephone_number": "612-505-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 E 82ND ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251365",
            "telephone_number": "612-505-3700",
            "fax_number": "952-600-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS EARLY DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "UBAH",
        "authorized_official_middle_name": "ISSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-322-0152"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.