NPIMap

Organization Active NPI

Valley Pain Relief and Wellness Center, PLLC

Doing business as Valley Medical and Wellness

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Burnsville, MN
National Provider Identifier
1871915470
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
VALLEY PAIN RELIEF AND WELLNESS CENTER, PLLC
Doing business as
Valley Medical and Wellness
Practice address
2428 E 117TH St
Burnsville, MN 55337-1269
Phone
(612) 444-3000
Fax
(612) 444-9000
NPI assigned
Jan 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Authorized official

Name
Ashwin Vinod GeorgeNPI 1518169713
Title
MD, VP, Ceo
Phone
(612) 444-3000

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X

Addresses

Primary practice location

2428 E 117TH St
Burnsville, MN 55337-1269

Mailing address

2428 E 117TH St
Burnsville, MN 55337-1269
Phone (612) 444-3000

Other names 1

  • Valley Medical and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140321001462 MN Part B Supplier - Clinic/Group Practice 7517198211 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burnsville, MN; Woodbury, MN; St Louis Park, MN; Rochester, MN; Minneapolis, MN; Bemidji, MN; Plymouth, MN
O20200501001070 MN Part B Supplier - Independent Clinical Laboratory 7517198211 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burnsville, MN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2438 E 117th St
Burnsville, MN 55337

2847 Johnson St NE
Minneapolis, MN 55418
Phone (612) 789-7277

14440 28th Pl N
Plymouth, MN 55447
Phone (763) 337-9676

1542 Assisi Dr NW
Rochester, MN 55901
Phone (507) 218-3460

3224 6th Ave NE
Unit B
Rochester, MN 55906

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1871915470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 E 117TH ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371269",
            "telephone_number": "612-444-3000",
            "fax_number": "612-444-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 E 117TH ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371269",
            "telephone_number": "612-444-3000",
            "fax_number": "612-444-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PAIN RELIEF AND WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "ASHWIN",
        "authorized_official_middle_name": "VINOD",
        "authorized_official_title_or_position": "MD, VP, CEO",
        "authorized_official_telephone_number": "612-444-3000"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Medical and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.