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ST PAUL RHEUMATOLOGY P A NPI 1053344788


NPI Information

NPI: 1053344788
Provider Name: ST PAUL RHEUMATOLOGY P A
Classification: Internal Medicine - 207RR0500X
Entity Type: Organization

Specialization: Rheumatology

CLIA Number: 24D1044701

Address:
2854 HIGHWAY 55
SUITE 190
EAGAN, MN
ZIP 55121
Phone: (651) 644-4277
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ST PAUL RHEUMATOLOGY P A is a rheumatology internal medicine in Eagan, MN. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. ST PAUL RHEUMATOLOGY P A NPI is 1053344788. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2854 HIGHWAY 55
SUITE 190
EAGAN, MN
ZIP 55121-156
Phone: (651) 644-4277

The provider's authorized official is David J Ridley .
The authorized official title is Owner and has the following contact phone number (651) 644-4277.

The CLIA number assigned to this NPI record is 24D1044701 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 5/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RR0500XInternal MedicineRheumatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1569199100MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.