GOOD CLINIC MN PLLC NPI 1003423252

NPI Information

NPI: 1003423252
Provider Name: GOOD CLINIC MN PLLC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Doing Business As: THE GOOD CLINIC
CLIA Number: 24D2230068
Address: 4712 EXCELSIOR BLVD
ST LOUIS PARK, MN
ZIP 55416
Phone: (844) 383-8689

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NPI Details

GOOD CLINIC MN PLLC is a primary care clinic center in St Louis Park, MN. GOOD CLINIC MN PLLC NPI is 1003423252. The provider is registered as an organization entity type.
The provider Is Doing Business As The Good Clinic.

The provider's business location address is:

4712 EXCELSIOR BLVD
ST LOUIS PARK, MN
ZIP 55416-008
Phone: (844) 383-8689

The provider's authorized official is Kevin Lee Smith .
The authorized official title is Chief Nurse Practitioner Officer and has the following contact phone number (763) 639-5327.

The CLIA number assigned to this NPI record is 24D2230068 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/30/2020 and was last updated on 1/14/2022.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes

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: 11/21/2025

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