NPIMap

Organization Active NPI

County of Blue Earth

  • Clinic/Center
  • Mankato, MN
National Provider Identifier
1023092954
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
800215 Issued in MN
Legal business name
COUNTY OF BLUE EARTH
Practice address
410 S 5TH St
Mankato, MN 56001-4588
Phone
(507) 304-4319
Fax
(507) 304-4387
NPI assigned
Dec 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Mr. Phil Claussen
Title
Director
Phone
(507) 304-4228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 800215 MN Primary

Addresses

Primary practice location

410 S 5TH St
Mankato, MN 56001-4588

Mailing address

410 S 5TH St
PO Box 3526
Mankato, MN 56001-4592
Phone (507) 304-4319

Other identifiers 1

IdentifierTypeStateIssuer
614755100MedicaidMN

Other names 1

  • Blue Earth County Human Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429000263 MN Part B Supplier - Clinic/Group Practice 0941297154 Receives reassigned benefits from 9 practitioners
Practice locations: Mankato, MN
O20240102000944 CO Part B Supplier - Clinic/Group Practice 0941297154 Receives reassigned benefits from 1 practitioner
Practice locations: Aurora, CO

National Provider Directory

National Provider Directory
Tax ID family
Blue Earth Co Human Ser5 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

410 S 5th St
Mankato, MN 56001
Phone (507) 304-4319

Practitioners & affiliated clinicians

Practitioners 10

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": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1023092954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S 5TH ST",
            "address_2": "PO BOX 3526",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014592",
            "telephone_number": "507-304-4319",
            "fax_number": "507-304-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 5TH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014588",
            "telephone_number": "507-304-4319",
            "fax_number": "507-304-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BLUE EARTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "CLAUSSEN",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "507-304-4228",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "800215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "614755100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Earth County Human Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.