NPIMap

Organization Active NPI

Piic Clinical Services

  • Primary Care Clinic/Center
  • Blaine, MN
National Provider Identifier
1053044149
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PIIC CLINICAL SERVICES
Practice address
4321 109TH Ave NE
Blaine, MN 55449-6794
Phone
(952) 698-9860
Fax
(833) 972-1581
NPI assigned
Jul 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Alethea Anderson
Title
Care Operations Manager
Phone
(952) 698-9860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4321 109TH Ave NE
Blaine, MN 55449-6794

Mailing address

323 Washington Ave N Ste 200
Minneapolis, MN 55401-2206
Phone (952) 698-9860

Other names 1

  • Campus Health Center 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
24D2262403Piic Clinical Services PC - Infinite Campus4321 109TH Ave NE, Blaine, MN 55449Certificate of waiverJun 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Piic Clinical Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

4321 109th Ave NE
Blaine, MN 55449
Phone (763) 726-9153

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1053044149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 WASHINGTON AVE N STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012206",
            "telephone_number": "952-698-9860",
            "fax_number": "612-930-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496794",
            "telephone_number": "952-698-9860",
            "fax_number": "833-972-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIIC CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2025-03-19",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ALETHEA",
        "authorized_official_title_or_position": "CARE OPERATIONS MANAGER",
        "authorized_official_telephone_number": "952-698-9860"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campus Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Campus Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.