NPIMap

Organization Active NPI

Minnesota State Colleges and Universities

Doing business as St. Cloud State University Medical Clinic and Counseling

  • Student Health Clinic/Center
  • Saint Cloud, MN
National Provider Identifier
1013993401
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
MINNESOTA STATE COLLEGES AND UNIVERSITIES
Doing business as
St. Cloud State University Medical Clinic and Counseling
Practice address
850 First Avenue South
Saint Cloud, MN 56301-4442
Phone
(320) 308-3191
Fax
(320) 308-3192
NPI assigned
Dec 19, 2005
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MINNESOTA STATE COLLEGE AND UNIVERSITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Kimberly Ohmann
Title
Asscoate Director
Phone
(320) 308-4872

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Primary Care Clinic/Center 261QP2300X
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

850 First Avenue South
Saint Cloud, MN 56301-4442

Mailing address

720 4TH Ave S
Saint Cloud, MN 56301-4442
Phone (320) 308-3191

Other identifiers 1

IdentifierTypeStateIssuer
1013993401MedicaidMN

Other names 1

  • St. Cloud State University Medical Clinic and Counseling 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
24D0041212St Cloud State University Medical Clinic850 1St St S, Saint Cloud, MN 56301AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Minnesota State Colleges Universities27 organizations share this tax ID, including this one
Part of
Minnesota State Colleges Universities

Other organizations with this tax ID 26

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

View all 26

Locations

720 4th Ave S
Saint Cloud, MN 56301
Phone (320) 308-3171

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1013993401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 4TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014442",
            "telephone_number": "320-308-3191",
            "fax_number": "320-308-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 FIRST AVENUE SOUTH",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014442",
            "telephone_number": "320-308-3191",
            "fax_number": "320-308-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA STATE COLLEGES AND UNIVERSITIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA STATE COLLEGE AND UNIVERSITIES",
        "enumeration_date": "2005-12-19",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "OHMANN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ASSCOATE DIRECTOR",
        "authorized_official_telephone_number": "320-308-4872"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013993401",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Cloud State University Medical Clinic and Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Cloud State University Medical Clinic and Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.