Divine Health LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DIVINE HEALTH LLC

Practice address

625 Snelling Ave N Ste a-2
Saint Paul, MN 55104-2878

Phone

(952) 288-9921

NPI assigned

Mar 4, 2022

Last updated

Mar 4, 2022By 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

Victor T Davis

Title

Co-Owner

Phone

(952) 288-9921

Specialties & licenses 1

Addresses

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.

• Victor Davis Patrick

  • Family Nurse Practitioner
  • Saint Paul, MN
  • NPI 1124494414
  NPD

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1871240267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A-2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042878",
            "telephone_number": "952-288-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A-2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042878",
            "telephone_number": "952-288-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "952-288-9921"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip M Ditmanson, MD
• Susan J Ditmanson, MD
• Anna Dittmann
• Alison Dittmer Flemig, MD
• Diversity Home Health Care, Inc.
• Divine Healthcare Corporation (Divine Healthcare Network)
• Divine Providence Homes LLC
• Colby Adams Dixon, M.D.
• Kerry A Dixon, APRN, APNP, CNM
• Michael L. Dixon, DC

• Family Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.