NPIMap

Organization Active NPI

Minnesota Doc

  • Health Service Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1932597002
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
R172606-6 Issued in MN
Legal business name
MINNESOTA DOC
Practice address
1450 Energy Park Dr
Saint Paul, MN 55108-5274
Phone
(651) 361-7200
Fax
(651) 642-0223
NPI assigned
Dec 24, 2014
Last updated
Mar 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. David A Paulson, MD
Title
Medical Director
Phone
(612) 390-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X R172606-6 MN Primary

Addresses

Primary practice location

1450 Energy Park Dr
Saint Paul, MN 55108-5274

Mailing address

1450 Energy Park Dr
Saint Paul, MN 55108-5274
Phone (651) 361-7200

National Provider Directory

National Provider Directory
Tax ID family
St Cloud State Univ HLT28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

1450 Energy Park Dr
Saint Paul, MN 55108
Phone (651) 361-7200

NPI Registry JSON

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

{
    "created_epoch": "1419379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1932597002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 ENERGY PARK DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085274",
            "telephone_number": "651-361-7200",
            "fax_number": "651-642-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 ENERGY PARK DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085274",
            "telephone_number": "651-361-7200",
            "fax_number": "651-642-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA DOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-24",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "PAULSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "612-390-4747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MN",
            "license": "R172606-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.