NPIMap

Organization Active NPI

Nucleus Clinic

  • Public Health or Welfare Agency
  • Coon Rapids, MN
National Provider Identifier
1982882742
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
NUCLEUS CLINIC
Practice address
1323 Coon Rapids Blvd NW
Coon Rapids, MN 55433-5362
Phone
(763) 755-5300
Fax
(763) 755-5301
NPI assigned
Feb 4, 2008
Last updated
Feb 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Authorized official

Name
Diane Lynn Hendrickson, CEO
Title
Cheif Executive Officer
Phone
(763) 755-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1323 Coon Rapids Blvd NW
Coon Rapids, MN 55433-5362

Mailing address

1323 Coon Rapids Blvd NW
Coon Rapids, MN 55433-5362
Phone (763) 755-5300

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0402983Nucleus Clinic1323 Coon Rapids Blvd NW, Coon Rapids, MN 55433Provider-performed microscopyApr 22, 2028

National Provider Directory

National Provider Directory

Locations

1323 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Phone (763) 755-5300

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1982882742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335362",
            "telephone_number": "763-755-5300",
            "fax_number": "763-755-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335362",
            "telephone_number": "763-755-5300",
            "fax_number": "763-755-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUCLEUS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "763-755-5300",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.