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INTEGRATED MED GROUP PLLC NPI 1609474998


NPI Information

NPI: 1609474998
Provider Name: INTEGRATED MED GROUP PLLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
2781 FREEWAY BLVD STE 160
BROOKLYN CENTER, MN
ZIP 55430
Phone: (763) 515-8799
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INTEGRATED MED GROUP PLLC is a medical specialty clinic center in Brooklyn Center, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). INTEGRATED MED GROUP PLLC NPI is 1609474998. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2781 FREEWAY BLVD STE 160
BROOKLYN CENTER, MN
ZIP 55430-765
Phone: (763) 515-8799
Fax: (763) 244-8021

The provider's authorized official is Jason Stadther .
The authorized official title is Ceo/owner and has the following contact phone number (763) 515-8799.

The enumeration date for this NPI number is 10/9/2020 and was last updated on 10/9/2020.


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
1363L00000XNurse PractitionerNo
2261QM2500XClinic/CenterMedical SpecialtyYes

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.