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PRIME FAMILY MEDICAL CLINIC
NPI 1306445853
Nurse Practitioner - Family in North Oaks, MN

Active since October 25, 2020CLIA 24D2202163 · Waiver
200 VILLAGE CENTER DR STE 800, NORTH OAKS, MN 55127(651) 219-8583(651) 800-9859 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prime Family Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME FAMILY MEDICAL CLINIC (NPI 1306445853) is a healthcare organization registered as a family in North Oaks, Minnesota and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through November 24, 2026 and lists Mindy Lee Kang, Ceo/np, as its authorized official.

NPPES Registry Identity

NPI1306445853
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePRIME FAMILY MEDICAL CLINIC
Location Address200 VILLAGE CENTER DR STE 800North Oaks, MN 55127-7092
Mailing Address200 Village Center Dr Ste 800North Oaks, MN 55127-7092 · (651) 219-8583 · Fax (651) 800-9859
Phone(651) 219-8583
Fax(651) 800-9859
Organization SubpartNo
Authorized OfficialMindy Lee KangCeo/np · (651) 219-8583
Enumeration DateOctober 25, 2020
Last NPPES UpdateMay 22, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1306445853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
200 VILLAGE CENTER DR STE 800, North Oaks, MN 55127
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2202163

Prime Family Medical Clinic · North Oaks, MN
Active · expires Nov 24, 2026
CLIA Number24D2202163
Laboratory TypePractitioner Other
Certificate Effective DateNovember 25, 2024
Certificate Expiration DateNovember 24, 2026
Laboratory DirectorMindy L. Kang
Laboratory Phone(651) 219-8583
Laboratory LocationPrime Family Medical Clinic200 Village Center Dr Suite #800, North Oaks, MN 55127
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINDY LEE KANG FNP-C.
Nurse Practitioner (Family)
200 VILLAGE CENTER DR STE 800
NORTH OAKS, MN 55127
Ramsey County (651) 219-8583
PRIME CHIROPRACTIC & REHAB CENTER
Chiropractor
200 VILLAGE CENTER DR STE 800
NORTH OAKS, MN 55127
Ramsey County (651) 235-9736
DR. DEREK JH KANG DC
Chiropractor
200 VILLAGE CENTER DR STE 800
NORTH OAKS, MN 55127
Ramsey County (678) 923-3568

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prime Family Medical Clinic's NPI number?

The NPI number for Prime Family Medical Clinic is 1306445853. It was assigned to this organization in the NPPES registry on October 25, 2020.

Where is Prime Family Medical Clinic located?

Prime Family Medical Clinic is located at 200 Village Center Dr Ste 800, North Oaks, MN 55127. The listed phone number is (651) 219-8583.

What is Prime Family Medical Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Prime Family Medical Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2202163) is associated with this NPI, valid through November 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Prime Family Medical Clinic accept?

Health plans from Medica list Prime Family Medical Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prime Family Medical Clinic was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.