CENTRAL MEDICAL WELLNESS & REGENERATION (NPI# 1336740364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336740364 |
| Entity Type | Organization |
| Organization Name | CENTRAL MEDICAL WELLNESS & REGENERATION |
| Practice Address |
821 Raymond Ave Ste 230 Saint Paul MN 55114-1503 |
| Mailing Address |
7595 Currell Blvd Unit 25404 Woodbury MN 55125-2569 |
| Practice Telephone | 6516446002 |
| Practice Fax Number | 6516471647 |
| Mailing Telephone | 6516446002 |
| Mailing Fax Number | 6516471647 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | ALFONSO MORALES-UTRILLA (OWNER) |
| Authorized Official Telephone | 6516446002 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
821 RAYMOND AVE STE 230 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1376166496 | Central Medical Wellness Inc | Family Medicine | 821 Raymond Ave Ste 230, Saint Paul, MN 55114-1503 | 2020-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| 1710263710 | University Adult Day Care Center Inc | Clinic/Center | 2434 University Ave W, Saint Paul, MN 55114 | 2011-10-23 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043836406 | Us Pain and Rehabilitation Center, Pa | Clinic/Center | 1997 Sloan Pl Ste 23, Saint Paul, MN 55117-2051 | 2020-06-22 |
| 1780090449 | Capitol Pain Management Pllc | Clinic/Center | 651 Arcade St, Saint Paul, MN 55106-4518 | 2014-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1689068462 | Group Health Plan, Inc. | Clinic/Center | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433 | 2015-03-19 |
| 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 |
| 1275881971 | Dodson Pain Consultants, P.a. Corp | Clinic/Center | 4600 Lake Road Ave Ste 301, Robbinsdale, MN 55422-1845 | 2012-08-28 |
| 1962774745 | Pain, Injury & Brain Centers of America Mn LLC | Clinic/Center | 14247 Oconnell Ct, Savage, MN 55378-2878 | 2012-02-08 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 55114 |
Please comment or provide details below to improve the information on CENTRAL MEDICAL WELLNESS & REGENERATION.
| 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.