Active NPI
Hra-Iq PC
- Geriatric Medicine (Family Medicine) Physician
- Edina, MN
National Provider Identifier
1891174751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- Legal business name
- HRA-IQ PC
- Practice address
- 4600 W 77TH St
#355
Edina, MN 55435-4909 - Phone
- (612) 741-2793
- NPI assigned
- May 26, 2015
- Organization subpart
- Yes
- Parent organization
- HRA-IQ INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Steve Pontius
- Title
- Ceo
- Phone
- (612) 741-2793
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | Primary |
Addresses
Primary practice location
4600 W 77TH St
#355
Edina, MN 55435-4909
Mailing address
4600 W 77TH St
#355
Edina, MN 55435-4909
National Provider Directory
National Provider DirectoryLocations
4600 77th St W
Ste 355
Edina, MN 55435
Phone (612) 741-2793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1432598400000",
"number": "1891174751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 W 77TH ST",
"address_2": "#355",
"city": "EDINA",
"state": "MN",
"postal_code": "554354909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 W 77TH ST",
"address_2": "#355",
"city": "EDINA",
"state": "MN",
"postal_code": "554354909",
"telephone_number": "612-741-2793"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HRA-IQ PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HRA-IQ INC",
"enumeration_date": "2015-05-26",
"last_updated": "2015-05-26",
"status": "A",
"authorized_official_last_name": "PONTIUS",
"authorized_official_first_name": "STEVE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "612-741-2793",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.