ST PAUL PRIMARY CARE NPI 1770972382

NPI Information

NPI: 1770972382
Provider Name: ST PAUL PRIMARY CARE
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Doing Business As: PARK AVE FAMILY PRACTICE
Address: 1345 THOMPSON AVE
SOUTH ST PAUL, MN
ZIP 55075
Phone: (651) 451-2711

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NPI Details

ST PAUL PRIMARY CARE is a primary care clinic center in South St Paul, MN. ST PAUL PRIMARY CARE NPI is 1770972382. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Ave Family Practice.

The provider's business location address is:

1345 THOMPSON AVE
SOUTH ST PAUL, MN
ZIP 55075-410
Phone: (651) 451-2711

The provider's authorized official is Karen Lee .
The authorized official title is Md and has the following contact phone number (612) 817-6690.

The enumeration date for this NPI number is 1/20/2015 and was last updated on 1/20/2015.

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	43414	MINNESOTA	Yes

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
1	100025256	MEDICAID	MINNESOTA
2	080022382	OTHER	MINNESOTA	MEDICARE 080022382

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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