PARK NICOLLET CLINIC – NPI #1780621904
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

PARK NICOLLET CLINIC is a provider located in SAINT LOUIS PARK, MN. NPPES has assigned the NPI number 1780621904 to PARK NICOLLET CLINIC on May 31, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 5 years ago on Oct 25, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PARK NICOLLET CLINIC below.

NPI Profile for
PARK NICOLLET CLINIC

NPI Number
1780621904
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PARK NICOLLET CLINIC
Primary location
3800 PARK NICOLLET BLVD
SAINT LOUIS PARK, MN 55416
Phone: (952) 993-3123 Fax: (952) 993-2770
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JASON LUHRS
VP FINANCE
Phone: (952) 883-7158
Updated
Certification Date
Oct 25, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
261QU0200X
- Clinic/Center / Urgent Care
208000000X
- Pediatrics
207V00000X
- Obstetrics & Gynecology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.