NPIMap

Organization Active NPI

Regions Hospital

Doing business as Phamacy - Outpatient Hospital

  • Pharmacy
  • Saint Paul, MN
National Provider Identifier
1013951748
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
REGIONS HOSPITAL
Doing business as
Phamacy - Outpatient Hospital
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3908
Fax
(651) 254-5649
NPI assigned
Jun 15, 2006
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
REGIONS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Authorized official

Name
John Clark
Title
Vice President, Finance
Phone
(651) 254-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3908

Other identifiers 5

IdentifierTypeStateIssuer
1132HPAOtherMNBLUE CROSS LEGACY ID
1016468OtherMNPREFERRED ONE LEGACY ID
21OtherMNHEALTHPARTNERS LEGACY ID
5009784OtherMNMEDICA LEGACY ID
422247400MedicaidMN

Other names 1

  • Phamacy - Outpatient Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080327000715 MN Part A Provider - Hospital 3173436755 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coon Rapids, MN; Maplewood, MN; Saint Paul, MN; Stillwater, MN; Woodbury, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013951748. Details of each certification follow.

Hospital certification: CCN 240106

Legal name
REGIONS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 17, 2013
Beds
554 (473 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 3, 1986 in MN
Enrollment address
640 Jackson St
Saint Paul, MN 55101-2502
Other Hospital Practice Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Regions HospitalCCN 240106 · All quality measures
Overall star rating
3 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
Tax ID family
Regions Hospital15 organizations share this tax ID, including this one
Part of
Regions Hospital

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Jennifer G Hines Individual Corporate Officer Jan 1, 2017
Corporate Director Jan 1, 2017
Bret C Haake Individual Corporate Officer Feb 18, 2022
Trista Matas Castillo Individual Corporate Director Jan 1, 2022
Tracy Wry Individual W-2 Managing EmployeeMGR Billing Operations May 3, 2023
Sangeeta Jain Individual Corporate Director Jan 1, 2023
Acooa Ellis Individual Corporate Director May 1, 2019
Mark R Sannes Individual Corporate Director Jan 1, 2022
Megan M Remark Individual Contracted Managing Employee Jan 1, 2015
Corporate DirectorMember- Board of Directors Jan 1, 2015
Armando Camacho Individual Corporate Director Jan 1, 2019
Andrea Walsh Individual Corporate Officer Jun 1, 2017
Corporate Director Jun 1, 2017
Jerome C Siy Individual Corporate Officer Apr 1, 2015
Corporate Director Apr 1, 2015
John Clark Individual Corporate Officer Mar 14, 2022
W-2 Managing Employee Sep 15, 2021
Penny Cermak Individual Corporate Director Jan 1, 2021
Lance Whitacre Individual Corporate Director Jan 1, 2019
Sheetal Kaul Individual Corporate Officer Feb 23, 2022
Alita R Risinger Individual Corporate OfficerSVP Cfo Care Delivery May 3, 2023
Angie Dillow Individual Corporate Director Jun 1, 2015
Hpi Ramsey Organization, Saint Paul, MN Non-profit Operational/Managerial Control Nov 29, 2007 100%
Other Nov 29, 2007 100%
Satasha Green Individual Corporate Director Jan 1, 2023
Linda Hanson Individual Corporate Director Jan 1, 2022

Owners & managing parties with NPI records 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 1,357

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

View all 1,357

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1013951748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3908",
            "fax_number": "651-254-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3908",
            "fax_number": "651-254-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGIONS HOSPITAL",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
        "authorized_official_telephone_number": "651-254-0900"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LEGACY ID",
            "identifier": "1132HPA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE LEGACY ID",
            "identifier": "1016468",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS LEGACY ID",
            "identifier": "21",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA LEGACY ID",
            "identifier": "5009784",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422247400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phamacy - Outpatient Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phamacy - Outpatient Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.