NPIMap

Organization Active NPI

Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1053952606
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
FAIRVIEW EXPRESS CARE
Practice address
2312 S 6TH St Ste F105
Minneapolis, MN 55454-1336
Phone
(612) 273-3565
NPI assigned
Oct 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Maureen Veronica Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2312 S 6TH St Ste F105
Minneapolis, MN 55454-1336

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other names 1

  • M Health Fairview Recovery Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081028000548 MN Part B Supplier - Clinic/Group Practice 3375645179 Receives reassigned benefits from 4,146 practitioners

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mesaba Clinic69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

2312 S 6th St
Ste F105
Minneapolis, MN 55454
Phone (612) 273-3565

Practitioners & affiliated clinicians

Practitioners 4,275

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

View all 4,275

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1053952606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 S 6TH ST STE F105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541336",
            "telephone_number": "612-273-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW EXPRESS CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "VERONICA",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M Health Fairview Recovery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Fairview Recovery Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.