NPIMap

Organization Active NPI

Allina Health System

Doing business as Cambridge Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Cambridge, MN
National Provider Identifier
1013194729
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
334635 Issued in MN
Legal business name
ALLINA HEALTH SYSTEM
Doing business as
Cambridge Medical Center
Practice address
701 Dellwood St S
Cambridge, MN 55008-1920
Phone
(763) 689-7700
NPI assigned
Jan 24, 2008
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dominica Tallarico
Title
Coo
Phone
(612) 222-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 334635 MN Primary

Addresses

Primary practice location

701 Dellwood St S
Cambridge, MN 55008-1920

Mailing address

PO Box 43
Mail Route 10860
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other names 1

  • Cambridge Medical Center Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20030505000032 MN Part A Provider - Hospital 4587573613 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cambridge, MN; Isanti, MN
O20031218000417 WI Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 522 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baldwin, WI; River Falls, WI; Grantsburg, WI; Prescott, WI
O20040319000460 MN Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 4,246 practitioners
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013194729. Details of each certification follow.

Hospital certification: CCN 240020

Legal name
ALLINA HEALTH SYSTEM
Doing business as
CAMBRIDGE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 1, 2012
Beds
86
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 28, 1983 in MN
Enrollment address
701 Dellwood St S
Cambridge, MN 55008-1920
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

Care Compare: Hospital

Medicare Care Compare
Listed as
Cambridge Medical CenterCCN 240020 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Challis Lowe Individual Corporate Director Jun 8, 2022
John Richard Church Individual Corporate Director Sep 9, 2021
Laura Jean Gillund Individual Corporate DirectorBoard Member Jun 10, 2015
Amy L Ronneberg Individual Corporate Director Dec 1, 2020
Daniel Thomas O'Laughlin Individual Corporate Director Jan 1, 2022
Maykao Y Hang Individual Corporate DirectorBoard Member Jun 13, 2019
Brian McGrane Individual Corporate DirectorBoard Member Jun 14, 2024
Marna Borgstrom Individual Corporate DirectorBoard Member Jun 13, 2025
Jennifer Soo Alstad Individual Corporate DirectorBoard Member Jun 10, 2016
Shari L Ballard Individual Corporate Director Jun 10, 2020
Timothy Aloysius Welsh Individual Corporate DirectorBoard Member Dec 1, 2017
Vicki Rasmusen Individual Corporate DirectorBoard Member Jun 13, 2019
Debbra Schoneman Individual Corporate Director Jun 13, 2013
James Kolar Individual Corporate DirectorBoard Member Sep 13, 2024
Lisa Shannon Individual Corporate DirectorPresident and Ceo Jan 1, 2022
Shawn M Ulreich Individual Corporate DirectorBoard Member Sep 13, 2023
Chanda L Baker Individual Corporate DirectorBoard Member Feb 20, 2024
Melinda Estes Individual Corporate DirectorBoard Member Jun 13, 2025
Louis Julius King Individual Corporate DirectorBoard Member Jun 12, 2017
Ruth Evelyn Williams-Brinkley Individual Corporate DirectorBoard Member Sep 13, 2023
Patricia W Schirmers Individual Corporate DirectorDirector Reimbursement May 5, 2003
W-2 Managing Employee May 5, 2003
Barbara a Butts Williams Individual Corporate DirectorBoard Member Jun 10, 2015
Thomas S Schreier Individual Corporate Director Mar 12, 2014
Dominica Marie Tallarico Individual Corporate OfficerCoo Mar 11, 2024
Roger Scott Newcome Individual Corporate DirectorManager May 6, 2016
W-2 Managing EmployeeManager May 6, 2016
Joshua Steven Shepherd Individual Corporate OfficerPresident May 11, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 299

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 299

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1013194729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MAIL ROUTE 10860",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELLWOOD ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081920",
            "telephone_number": "763-689-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "TALLARICO",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "612-222-2222"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "MN",
            "license": "334635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cambridge Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cambridge Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MN

Sources for this page

Verify at the official NPI Registry.