INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC


Address: 2301 Connecticut Avenue South, Sartell, MN 56377-2474
Phone: 3202291500

INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC (NPI# 1013056969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013056969
Entity Type Organization
Organization Name INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC
Practice Address 2301 Connecticut Avenue South
Sartell
MN 56377-2474
Practice Telephone 3202291500
Practice Fax Number 3202291505
Mailing Telephone 3202291500
Mailing Fax Number 3202291505
Enumeration Date 2007-02-06
Last Update Date 2015-07-14
Authorized Official Name MRS. STACY KOWALKOWSKI (ADMINISTRATOR)
Authorized Official Telephone 3202291500
Authorized Official Credential R.N.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QP2000X Clinic/Center
Specialization: Physical Therapy
41961 MN Ambulatory Health Care Facilities
N 208100000X Physical Medicine & Rehabilitation 41961 MN Allopathic & Osteopathic Physicians
N 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
41961 MN Allopathic & Osteopathic Physicians
Y 261QP3300X Clinic/Center
Specialization: Pain
41961 MN Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MN MEDICARE PTAN C03449 01
MN 410645800 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1184978280 Interventional Pain & Physical Medicine Clinic Clinic/Center 2301 Connecticut Ave S, Sartell, MN 56377-2474 2012-10-29
1710230800 Interventional Pain & Physical Medicine Clinic Durable Medical Equipment & Medical Supplies 2301 Connecticut Ave S, Sartell, MN 56377-2474 2012-10-26
1265784862 Interventional Pain & Physical Medicine Clinic Clinic/Center 2301 Connecticut Ave S, Sartell, MN 56377-2474 2012-10-05

Office Location

Street Address 2301 CONNECTICUT AVENUE SOUTH
City SARTELL
State MN
Zip Code 56377-2474

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477569606 Thomas Christopher Kowalkowski Pain Medicine 2301 Connecticut Avenue South, Sartell, MN 56377-2474 2006-07-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235783515 Chae Norman Massage Therapist 303 4th Ave S, Suite C, Sartell, MN 56377 2019-07-25
1497317259 Stephanie Maria Schaefer Behavioral Analyst 1133 Mockingbird Loop, Sartell, MN 56377 2019-07-02
1538722848 Madison Toughill Behavior Technician 205 14th Ave E, Sartell, MN 56377 2019-04-22
1902388671 Julie Ann Helms Counselor 101 Dehler Dr., Sartell, MN 56377 2018-08-30
1104337617 Louis Chester Winskowski IIi Orthotist 50 14th Ave E Suite 114, Sartell, MN 56377 2017-10-24
1962958611 Centracare Clinic Exclusive Provider Organization 166 19th Street S, Suite 202, Sartell, MN 56377 2016-08-31
1295197846 Mindful Healing & Training Counselor 1417 15th Street South, Sartell, MN 56377 2016-03-23
1710342894 Saint Cloud Hospital St. Benedict's Senior Community Skilled Nursing Facility 990 19th St. S., Sartell, MN 56377 2015-12-16
1932452661 David Peter Pogatchnik Pharmacist 2251 Connecticut Ave. South, Health Partners Central Minnesota Clinics (pharmacy), Sartell, MN 56377 2012-10-18
1669759866 Lakewood Health System Clinic/Center 161 19th St S Ste 106, Sartell, MN 56377 2011-11-16
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Taxonomy Information

Taxonomy Code 261QP3300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Pain

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437758471 Hpm of Minnesota Pllc Clinic/Center 49725 Co Rd 83, Staples, MN 56479 2020-10-21
1902356868 Metro Mn Pain Center, LLC Clinic/Center 3260 County Road 10, Suite G, Brooklyn Center, MN 55429-3076 2016-10-04
1104286772 Pain Clinics of Minnesota P.a. Clinic/Center 4600 Oak Grove Parkway, Brooklyn Park, MN 55443 2016-02-25
1144563503 Nura Pa Clinic/Center 9550 Upland Lane N, Suite 120, Maple Grove, MN 55369-4481 2013-04-03
1780974998 Light Mountain Healthworks Inc. Clinic/Center 502 Hidden Trail Ct Sw, Bemidji, MN 56601-2569 2011-04-10
1043836406 Us Pain and Rehabilitation Center, Pa Clinic/Center 1997 Sloan Pl Ste 23, Saint Paul, MN 55117-2051 2020-06-22
1689068462 Group Health Plan, Inc. Clinic/Center 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433 2015-03-19
1780090449 Capitol Pain Management Pllc Clinic/Center 651 Arcade St, Saint Paul, MN 55106-4518 2014-07-02
1003159567 Nura Pa Clinic/Center 7390 France Ave S, Edina, MN 55435-4500 2013-04-03
1629311089 Nura Pa Clinic/Center 2104 Northdale Blvd Nw, Suite 220, Minneapolis, MN 55433-3046 2013-04-03
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Competitor

Search similar providers

City SARTELL
Zip Code 56377

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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