Organization Active NPI

Occupational and Manual Medicine of Duluth

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Duluth, MN
National Provider Identifier
1821251455
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
30428 Issued in MN
Legal business name
OCCUPATIONAL AND MANUAL MEDICINE OF DULUTH
Practice address
1420 London Rd
Suite 102B
Duluth, MN 55805-2433
Phone
(218) 724-6002
NPI assigned
Jul 3, 2008
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Sharon Obst
Title
Manager
Phone
(218) 724-6002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 30428 MN Primary

Addresses

Primary practice location

1420 London Rd
Suite 102B
Duluth, MN 55805-2433

Mailing address

1420 London Rd
Suite 102B
Duluth, MN 55805-2433
Phone (218) 724-6002

Other identifiers 1

IdentifierTypeStateIssuer
264783400MedicaidMN

National Provider Directory

National Provider Directory

Locations

1420 London Rd
Ste 102B
Duluth, MN 55805
Phone (218) 724-6000

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1821251455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 102B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-724-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 LONDON RD",
            "address_2": "SUITE 102B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052433",
            "telephone_number": "218-724-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL AND MANUAL MEDICINE OF DULUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "OBST",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "218-724-6002"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MN",
            "license": "30428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264783400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.