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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | MEDICARE PTAN | C03449 | 01 |
MN | 410645800 | 05 |
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 |
Street Address |
2301 CONNECTICUT AVENUE SOUTH |
City | SARTELL |
State | MN |
Zip Code | 56377-2474 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477569606 | Thomas Christopher Kowalkowski | Pain Medicine | 2301 Connecticut Avenue South, Sartell, MN 56377-2474 | 2006-07-31 |
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 |
Find all providers in zip 56377 |
Taxonomy Code | 261QP3300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Pain |
Definition to come... |
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---|---|---|---|---|
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 |
Find all providers with the same taxonomy |
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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.