Palliative Providers, PA

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PALLIATIVE PROVIDERS, PA

Practice address

4707 Highway 61 N Ste 116
White Bear Lake, MN 55110-3227

Phone

(651) 247-4727

NPI assigned

Oct 5, 2023

Last updated

Oct 5, 2023By 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

Thomas V Soukup, DONPI 1891087953

Title

Physician

Phone

(651) 247-4727

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas V. Soukup, D.O.

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Minneapolis, MN
  • NPI 1891087953
  NPD Authorized official

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1952181935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 HIGHWAY 61 N STE 116",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103227",
            "telephone_number": "651-247-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 HIGHWAY 61 N STE 116",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103227",
            "telephone_number": "651-247-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALLIATIVE PROVIDERS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "SOUKUP",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "651-247-4727",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie L Osbeck, DDS
• Jonathan Otten, ND
• Jacob Ozment
• Emily Yajaira Padilla, DDS
• Pain Relief and Wellness of Minnesota (Locketz Rehabilitation)
• Victoria Rose Palme, PA-C
• Mary M Paquette, MD
• Matthew J Paquette, MD
• Emea Pauline Hipolito Parungao
• Melissa Pascoe, LGSW

• Community Based Hospice Care Agency in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.