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MINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC
NPI 1447857230
General Practice in Wayzata, MN

Active since October 05, 2020CLIA 24D2171701 · Waiver
1120 WAYZATA BLVD E STE 110, WAYZATA, MN 55391(952) 222-7670(763) 210-6809 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2024, Oct 5, 2020 (2 updates tracked since 2020).

About Minneapolis Integrative Medicine Center, Llc NPPES

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

MINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC (NPI 1447857230) is a healthcare organization registered as a general practice in Wayzata, Minnesota and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through September 6, 2027 and lists Cassandra Wilder, Owner, as its authorized official.

NPPES Registry Identity

NPI1447857230
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMINNEAPOLIS INTEGRATIVE MEDICINE CENTER, LLC
Location Address1120 WAYZATA BLVD E STE 110Wayzata, MN 55391-1984
Mailing Address1120 Wayzata Blvd E Ste 110Wayzata, MN 55391-1984 · (952) 222-7670 · Fax (763) 210-6809
Phone(952) 222-7670
Fax(763) 210-6809
Organization SubpartNo
Authorized OfficialCassandra WilderOwner · (952) 222-7670
Enumeration DateOctober 5, 2020
Last NPPES UpdateMay 8, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2024
✔ NPI 1447857230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1120 WAYZATA BLVD E STE 110, Wayzata, MN 55391
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 24D2171701

Minneapolis Integrative Medicine Center · Minneapolis, MN
Active · expires Sep 6, 2027
CLIA Number24D2171701
Laboratory TypePhysician Office
Certificate Effective DateSeptember 7, 2025
Certificate Expiration DateSeptember 6, 2027
Laboratory DirectorCassandra L. Wilder
Laboratory Phone(952) 222-7670
Laboratory LocationMinneapolis Integrative Medicine Center575 SE 9th St Suite 52, Minneapolis, MN 55414
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 4

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

ANDREA BARNES NP
Nurse Practitioner (Primary Care)
1120 WAYZATA BLVD E STE 110
WAYZATA, MN 55391
Hennepin County (952) 222-7670
ALEXANDRA QUINN ND
Naturopath
1120 WAYZATA BLVD E STE 110
WAYZATA, MN 55391
Hennepin County (952) 222-7670
EMILY KOS ND
Naturopath
1120 WAYZATA BLVD E STE 110
WAYZATA, MN 55391
Hennepin County (952) 222-7670
DR. CASSANDRA WILDER NMD
Naturopath
1120 WAYZATA BLVD E STE 110
WAYZATA, MN 55391
Hennepin County (952) 222-7670

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 Minneapolis Integrative Medicine Center, LLC's NPI number?

The NPI number for Minneapolis Integrative Medicine Center, LLC is 1447857230. It was assigned to this organization in the NPPES registry on October 5, 2020.

Where is Minneapolis Integrative Medicine Center, LLC located?

Minneapolis Integrative Medicine Center, LLC is located at 1120 Wayzata Blvd E Ste 110, Wayzata, MN 55391. The listed phone number is (952) 222-7670.

What is Minneapolis Integrative Medicine Center, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Minneapolis Integrative Medicine Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2171701) is associated with this NPI, valid through September 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Minneapolis Integrative Medicine Center, LLC was last updated on May 8, 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.