EDDICTION MEDICINE PLLC – NPI #1043818354
Preventive Medicine

A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

EDDICTION MEDICINE PLLC is a provider located in LINDSTROM, MN. NPPES has assigned the NPI number 1043818354 to EDDICTION MEDICINE PLLC on October 09, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2083A0300X from the Health Care Provider Taxonomy code set, which is classified as Preventive Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 5 years ago on May 04, 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 EDDICTION MEDICINE PLLC below.

NPI Profile for
EDDICTION MEDICINE PLLC

NPI Number
1043818354
Enumeration Date

(more than 5 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
EDDICTION MEDICINE PLLC
Primary location
12018 285TH STREET
LINDSTROM, MN 55045
Phone: (612) 393-1212 Fax: (651) 400-3892
Mailing address
PO BOX 833
LINDSTROM, MN 55045-0833
Phone: (612) 393-1212 Fax: (651) 257-9422
Organization Subpart
No
Authorized Official
CORI MYER
OFFICE STAFF
Phone: (612) 393-1212
Updated
Certification Date
May 04, 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.

Identifiers

Identifiers for EDDICTION MEDICINE PLLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMN1932488608
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
2083A0300X
- Preventive Medicine / Addiction Medicine (Primary)

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.