Pain Centers of Minnesota - Stillwater, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN CENTERS OF MINNESOTA - STILLWATER, LLC

Practice address

1950 Curve Crest Blvd W
Stillwater, MN 55082-5078

Phone

(763) 537-6000

Fax

(763) 537-6666

NPI assigned

May 20, 2015

Organization subpart

No

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

Authorized official

Name

Vishal Lal

Title

Chief Executive Officer

Phone

(414) 325-7246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1922487149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212059",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825078",
            "telephone_number": "763-537-6000",
            "fax_number": "763-537-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CENTERS OF MINNESOTA - STILLWATER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "LAL",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "414-325-7246"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sarah Oster, RD, LD
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• Bunmi Sara Oyegade
• Paul L Paladie, MSW,LMSW, LICSW,LADC
• Joan Palen
• Brianna Lee Pankratz, APRN, CNP
• Jane Teresa Paquette
• Paragon Psychiatric Nursing Services

• Ambulatory Surgical Clinic/Center in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.