Advanced Spine and Pain Clinics of Minnesota LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

ADVANCED SPINE AND PAIN CLINICS OF MINNESOTA LLC

Practice address

2801 Wayzata Blvd
Minneapolis, MN 55405-2125

Phone

(612) 207-7463

Fax

(612) 315-4473

NPI assigned

May 24, 2012

Last updated

Feb 7, 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

Dr. Matthew Gerald Thorson, M.D.

Title

President/Owner

Phone

(612) 207-7463

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Advanced Spine and Pain Clinics of MN, LLC

  • Non-Pharmacy Dispensing Site
  • Buffalo, MN
  • NPI 1346653052
  NPPES parent name

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1891055851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052125",
            "telephone_number": "612-207-7463",
            "fax_number": "952-831-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052125",
            "telephone_number": "612-207-7463",
            "fax_number": "612-315-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE AND PAIN CLINICS OF MINNESOTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2022-02-07",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "THORSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "612-207-7463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "530615900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Minneapolis",
            "affiliation": "N",
            "address_1": "2801 Wayzata Blvd",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554052125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pain Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pain Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.