Active NPI
Vickie L Nash, MD
- Obstetrics & Gynecology Physician
- St Cloud, MN
National Provider Identifier
1033100987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 30017
- Practice address
- 1900 Centracare Circle
St Cloud, MN 56303 - Phone
- (320) 654-3630
- Fax
- (320) 654-3657
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 30017 | MN | Primary |
Addresses
Primary practice location
1900 Centracare Circle
St Cloud, MN 56303
Mailing address
1900 Centracare Circle
St Cloud, MN 56303
Phone (320) 654-3630
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50A50NA | Other | BLUE CROSS BLUE SHIELD | |
| 836595400 | Other | MEDICAL ASSISTANCE | |
| 110424 | Other | U-CARE | |
| 2113977 | Other | FIRST HEALTH PLAN | |
| 160001180 | Other | MEDICARE | |
| 254012 | Other | PREFERRED ONE | |
| 556195 | Other | ARAZ GRP/AMERICA'S PPO | |
| HP25493 | Other | HEALTH PARTNERS | |
| 0702777 | Other | MEDICA HEALTH PLANS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30017 | MN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- St Joseph, MN
- NPI 1134121759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1033100987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 CENTRACARE CIRCLE",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-654-3630",
"fax_number": "320-654-3657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 CENTRACARE CIRCLE",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "56303",
"telephone_number": "320-654-3630",
"fax_number": "320-654-3657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "VICKIE",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MN",
"license": "30017",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "50A50NA",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "836595400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U-CARE",
"identifier": "110424",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH PLAN",
"identifier": "2113977",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "160001180",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "254012",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ GRP/AMERICA'S PPO",
"identifier": "556195",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25493",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "0702777",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in St Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.