Organization Active NPI

St Joseph'S Area Health Services

  • Clinic/Center
  • Park Rapids, MN
National Provider Identifier
1013460864
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ST JOSEPH'S AREA HEALTH SERVICES
Practice address
600 Pleasant Ave S
Park Rapids, MN 56470-1431
Phone
(218) 616-3700
Fax
(218) 616-3737
NPI assigned
Jul 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Ben Koppelman
Title
Ceo/President
Phone
(218) 616-3500

Specialties & licenses 1

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

Addresses

Primary practice location

600 Pleasant Ave S
Park Rapids, MN 56470-1431

Mailing address

600 Pleasant Ave S
Park Rapids, MN 56470-1431
Phone (218) 616-3700

Other identifiers 1

IdentifierTypeStateIssuer
CE9455OtherMNRR MEDICARE

Other names 1

  • CHI ST. JOSEPH'S HEALTH CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000521 MN Part B Supplier - Clinic/Group Practice 0345146510 Receives reassigned benefits from 65 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Park Rapids, MN

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

3314 Solutions Ctr
Chicago, IL 60677

323 Main Ave S
Park Rapids, MN 56470
Phone (218) 237-5593

1004 1st St W
Park Rapids, MN 56470
Phone (218) 237-5760

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1013460864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701431",
            "telephone_number": "218-616-3700",
            "fax_number": "218-616-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701431",
            "telephone_number": "218-616-3700",
            "fax_number": "218-616-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH'S AREA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "KOPPELMAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "218-616-3500"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE9455",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI ST. JOSEPH'S HEALTH CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.