PAIN SPECIALIST OF MINNESOTA
NPI 1508562240
Nurse Practitioner - Family in St Louis Park, MN

NPI Status: Active since February 03, 2023

Contact Information

5810 EXCELSIOR BLVD
ST LOUIS PARK, MN
ZIP 55416
Phone: (612) 235-6008
Fax: (612) 235-6003

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 24D2286335
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-26-2027

About PAIN SPECIALIST OF MINNESOTA

This page provides the complete NPI Profile along with additional information for Pain Specialist Of Minnesota, a provider established in St Louis Park, Minnesota operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1508562240 assigned on February 2023. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mark Stock (Ceo)

NPI
1508562240
Provider Name
PAIN SPECIALIST OF MINNESOTA
Entity Type
Organization
Location Address
5810 EXCELSIOR BLVD ST LOUIS PARK, MN 55416
Location Phone
(612) 235-6008
Location Fax
(612) 235-6003
Mailing Address
5810 EXCELSIOR BLVD ST LOUIS PARK, MN 55416
Mailing Phone
(612) 235-6008
Mailing Fax
(612) 235-6003
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-03-2023
Last Update Date
01-22-2025
Code Navigator

A nurse practitioner (NP) like Pain Specialist Of Minnesota is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARK STOCK

Authorized Official Title
CEO
Authorized Official Phone
(651) 238-8580

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2286335
Facility Type
Physician Office
Certificate Effective Date
July 27, 2025
Certificate Expiration Date
July 26, 2027
Laboratory Director
MARK J. STOCK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pain Specialist Of Minnesota to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1508562240, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
0
Doubled → 0
Pos 4
8
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
4
Doubled → 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 2 → 4 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 0 + 8 + 1 + 0 + 6 + 4 + 2 + 8 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1508562240.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Chiropractor
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Massage Therapist
5810 EXCELSIOR BLVD, C/O SPINE CARE, PA.
ST LOUIS PARK, MN 55416
Massage Therapist
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Massage Therapist
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Massage Therapist
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Chiropractor
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Nurse Practitioner (Family)
5810 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508562240, enumerated as an "organization" on February 03, 2023.

The provider is located at 5810 EXCELSIOR BLVD ST LOUIS PARK, MN 55416 and the phone number is (612) 235-6008.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.