Oakdale Family Practice, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

24D0670882 Issued in MN

Legal business name

OAKDALE FAMILY PRACTICE, PC

Practice address

3366 Oakdale Ave N
Suite 403
Robbinsdale, MN 55422-2948

Phone

(763) 529-9131

Fax

(763) 529-5519

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gene Wayne Velasco, MD

Title

Owner

Phone

(763) 529-9131

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1841388964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 403",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-529-9131",
            "fax_number": "763-529-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 403",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-529-9131",
            "fax_number": "763-529-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKDALE FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "VELASCO",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-529-9131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "24D0670882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH8589",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA376",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767798700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "487659600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "P153",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "06744HA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Nye
• Nicole Deborah Nyquist, LMT
• Susan O'Brien, CNP
• Hillarie Jo O'Loughlin
• Brian Thomas O'Neill, M.D.
• Chike Uchenna Anthony Obi
• Occupational Health Centers of Minnesota PC
• Kimberly Oelhafen, MD
• Olufunmilola A Okanla-Falade, LICSW
• Sanford Alan Olevitch, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.