NPIMap

Organization Active NPI

Olmsted Medical Center

Doing business as OMC Skyway Clinic

  • Clinic/Center
  • Rochester, MN
National Provider Identifier
1013277789
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OLMSTED MEDICAL CENTER
Doing business as
OMC Skyway Clinic
Practice address
318 1St Ave SW
Suite 203
Rochester, MN 55902-3310
Phone
(507) 529-6616
NPI assigned
May 29, 2012
Last updated
May 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Authorized official

Name
Kevin Higgins
Title
Cfo
Phone
(507) 529-6619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MN Primary

Addresses

Primary practice location

318 1St Ave SW
Suite 203
Rochester, MN 55902-3310

Mailing address

201 9TH St SE
Rochester, MN 55904-6768
Phone (507) 592-6616

Other names 1

  • OMC Skyway Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2002497Olmsted Medical Center - Skyway Clinic318 1St Avenue SW Suite 203, Rochester, MN 55902Certificate of waiverJan 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Olmsted Med PA Supply5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

201 9th St SE
Rochester, MN 55904
Phone (507) 281-3532

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1013277789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046768",
            "telephone_number": "507-592-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 1ST AVE SW",
            "address_2": "SUITE 203",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023310",
            "telephone_number": "507-529-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLMSTED MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "507-529-6619"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMC Skyway Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.