INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC (NPI# 1265784862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265784862 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC |
| Practice Address |
2301 Connecticut Ave S Sartell MN 56377-2474 |
| Practice Telephone | 3202291500 |
| Practice Fax Number | 3202291505 |
| Mailing Telephone | 3202291500 |
| Mailing Fax Number | 3202291505 |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2012-10-05 |
| Authorized Official Name | MRS. STACY KOWALKOWSKI (ADMINISTRATOR) |
| Authorized Official Telephone | 3202291500 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| 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 |
| 1013056969 | Interventional Pain & Physical Medicine Clinic | Clinic/Center | 2301 Connecticut Avenue South, Sartell, MN 56377-2474 | 2007-02-06 |
| Street Address |
2301 CONNECTICUT AVE S |
| City | SARTELL |
| State | MN |
| Zip Code | 56377-2474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730338377 | Michelle Marie Burton | Physical Therapist | 2301 Connecticut Ave S, Sartell, MN 56377 | 2008-09-18 |
| 1740888536 | Kasi Zack | Nurse Practitioner | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2020-10-13 |
| 1063023828 | Isaiah Schwindt | Physical Therapist | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2020-08-13 |
| 1407499023 | Bernadette T Warnert | Nurse Practitioner | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2019-10-27 |
| 1609342203 | Matthew Thomas Baltus | Physical Therapist | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2018-10-22 |
| 1669858023 | Timothy Jerome Binsfeld | Physical Therapist | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2015-08-07 |
| 1962830026 | Carissa Arens | Nurse Practitioner | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2013-10-28 |
| 1528407426 | Carolyne Kukla | Physical Therapist | 2301 Connecticut Ave S, Sartell, MN 56377-2474 | 2013-06-24 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912283334 | New Directions for Change | Clinic/Center | 6500 Brooklyn Blvd - Lower Level, Brooklyn Center, MN 55429 | 2011-10-31 |
| 1982922324 | Juel Fairbanks Chemical Dependency Services | Clinic/Center | 804 Albert St N, Saint Paul, MN 55104 | 2010-05-10 |
| 1376514539 | Pediatric Therapy Services Inc | Clinic/Center | 150 Saint Andrews Ct, Suite 310, Mankato, MN 56001-8659 | 2006-01-27 |
| 1184768277 | Rice Memorial Hospital | Clinic/Center | 301 Becker Ave Sw, Willmar, MN 56201-3302 | 2007-02-20 |
| 1851388920 | Medcentra LLC | Clinic/Center | 225 Smith Ave N, Suite 301, Saint Paul, MN 55102-2534 | 2005-10-04 |
Please comment or provide details below to improve the information on INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC.
| 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.