Organization Active NPI

The Childrens Heart Clinic P,a

  • Pediatric Cardiology Physician
  • Minneapolis, MN
National Provider Identifier
1962580274
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
THE CHILDRENS HEART CLINIC P,A
Practice address
2530 Chicago Ave
Suite 500
Minneapolis, MN 55404-4291
Phone
(612) 813-8800
Fax
(612) 813-8825
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Mrs. Sossia Miller Lake
Title
Clinic Operations Coordinator
Phone
(612) 813-8801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

2530 Chicago Ave
Suite 500
Minneapolis, MN 55404-4291

Mailing address

2530 Chicago Ave
Suite 500
Minneapolis, MN 55404-4291
Phone (612) 813-8800

National Provider Directory

National Provider Directory

Locations

4040 Coon Rapids Blvd NW
Ste 100
Coon Rapids, MN 55433
Phone (651) 917-6161

6060 Clearwater Dr
Ste 110
Minnetonka, MN 55343
Phone (612) 813-8800

347 Smith Ave N
Ste 603
Saint Paul, MN 55102
Phone (612) 813-8800

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1962580274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE",
            "address_2": "SUITE 500",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044291",
            "telephone_number": "612-813-8800",
            "fax_number": "612-813-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDRENS HEART CLINIC P,A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "SOSSIA",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "CLINIC OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "612-813-8801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.