Medical Addiction Treatment Clinic

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

52519 Issued in MN

Legal business name

MEDICAL ADDICTION TREATMENT CLINIC

Practice address

3805 Washington Ave N
Minneapolis, MN 55412-2141

Phone

(612) 887-6282

Fax

(612) 437-4992

NPI assigned

Dec 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Anne M Pylkas, MD

Title

Ceo

Phone

(612) 435-7380

Specialties & licenses 4

Addresses

Other names 1

• Sage Prairie Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Sage Prairie Laboratory

  • Other Specialist/Technologist
  • Eagan, MN
  • NPI 1164089447
  NPPES parent name

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1891031209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 WASHINGTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122141",
            "telephone_number": "612-887-6282",
            "fax_number": "612-437-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 WASHINGTON AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122141",
            "telephone_number": "612-887-6282",
            "fax_number": "612-437-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ADDICTION TREATMENT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "PYLKAS",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-435-7380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MN",
            "license": "52519",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12684",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sage Prairie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Meadows, MT-BC
• Jonee Elizabeth Meagher, O.D.
• Meaningful Healing Therapy LLC
• Jolyn Means, LPN
• McKinley Hruby Medhaug
• Medical Equipment Services LLC
• Medical Services Center
• Medilink Transport LLC
• Medilink Transport LLC
• Cheryl Medin, PTA

• Addiction Medicine (Internal Medicine) Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Addiction Medicine (Internal Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.