CENTRAL MEDICAL CLINIC, PLLC. (NPI# 1053704635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053704635 |
| Entity Type | Organization |
| Organization Name | CENTRAL MEDICAL CLINIC, PLLC. |
| Practice Address |
393 Dunlap St N Ll34 Saint Paul MN 55104-4200 |
| Practice Telephone | 6516446002 |
| Practice Fax Number | 6516471647 |
| Mailing Telephone | 6516446002 |
| Mailing Fax Number | 6516471647 |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-03-06 |
| Authorized Official Name | MRS. CHRISTINE MORALES (CLINIC DIRECTOR) |
| Authorized Official Telephone | 6516446002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1123204 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
393 DUNLAP ST N LL34 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912909557 | Minnesota Hand Rehabilitation Inc | Occupational Therapist | 393 Dunlap St N, Suite 736, Saint Paul, MN 55104-4200 | 2005-08-12 |
| 1487003760 | Idil Ahmed Mohamed | Home Health | 393 Dunlap St N, Ste 400m, Saint Paul, MN 55104-4200 | 2016-06-08 |
| 1114373511 | Sana Home Health Services | Home Health | 393 Dunlap St N, Suite Ll38, Saint Paul, MN 55104-4200 | 2016-05-04 |
| 1730552670 | Soma Transportation Co | Non-emergency Medical Transport (VAN) | 393 Dunlap St N, Ste 450, Saint Paul, MN 55104-4200 | 2015-10-31 |
| 1740652767 | All Nation Transportation Service LLC | Non-emergency Medical Transport (VAN) | 393 Dunlap St N, # 400k, Saint Paul, MN 55104-4200 | 2015-10-29 |
| 1033581087 | Hopewell Audiology, LLC | Clinic/Center | 393 Dunlap St N, Suite 115, Saint Paul, MN 55104-4200 | 2015-10-28 |
| 1518337294 | Rebecca Ann Younk | Audiologist | 393 Dunlap St N, Suite 115, Saint Paul, MN 55104-4200 | 2015-10-06 |
| 1801272323 | Tamiko Ralston | Counselor | 393 Dunlap St N, 400h, Saint Paul, MN 55104-4200 | 2015-08-06 |
| 1154715340 | Mn Chiropractic & Acupuncture, Pa | Chiropractor | 393 Dunlap St N, Suite 725, Saint Paul, MN 55104-4200 | 2015-03-25 |
| 1487067153 | Client Centered Care | Custodial Care Facility | 393 Dunlap St N, Suite 105, Saint Paul, MN 55104-4200 | 2014-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1003258690 | Jenny Rebecca Kluznik | Physician Assistant | 1619 Dayton Ave Ste 205, Saint Paul, MN 55104 | 2013-07-23 |
| 1538439534 | Meghan Eileen Goff | Physician Assistant | 212 7th St E, Apt 204, Saint Paul, MN 55101-2373 | 2012-01-06 |
| 1003899527 | Christopher Lawrence Kaye | Physician Assistant | 640 Jackson Street, Saint Paul, MN 55101 | 2005-11-29 |
| 1578113932 | Alyssa Shenyeng Moualee | Physician Assistant | 1239 Payne Ave, Saint Paul, MN 55130-3667 | 2019-09-18 |
| 1790338754 | Mikaela Pierson | Physician Assistant | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-07-18 |
| 1508425711 | Sopida N/a Wunder | Physician Assistant | 1983 Sloan Pl Ste 11, Saint Paul, MN 55117-2004 | 2019-06-11 |
| 1780159533 | Andrew Kenneth Gernand | Physician Assistant | 640 Jackson St, Saint Paul, MN 55101-2595 | 2018-10-08 |
| 1205350204 | Soua Vang | Physician Assistant | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117-2095 | 2017-08-01 |
| 1588184634 | Katharine Elizabeth Boyd | Physician Assistant | 333 Smith Ave N, Saint Paul, MN 55102-2344 | 2017-06-20 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
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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.