NPIMap

Organization Active NPI

Catholic Charities of the Archdiocese of St Paul and MPLS

Doing business as St Josephs Community Health Clinic

  • Community Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1063592434
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
Legal business name
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF ST PAUL AND MPLS
Doing business as
St Josephs Community Health Clinic
Practice address
1121 E 46TH St
Minneapolis, MN 55407-3562
Phone
(612) 204-8387
NPI assigned
Oct 17, 2006
Last updated
Jan 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Yolanda O'Reilly
Title
Billing MGR
Phone
(612) 204-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LC1500X MN Primary

Addresses

Primary practice location

1121 E 46TH St
Minneapolis, MN 55407-3562

Mailing address

1200 2ND Ave S
Minneapolis, MN 55403-2513
Phone (612) 204-8387

Other identifiers 1

IdentifierTypeStateIssuer
699726100MedicaidMN

Other names 1

  • St Josephs Community Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of St Paulmpls6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1063592434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 2ND AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032513",
            "telephone_number": "612-204-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E 46TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073562",
            "telephone_number": "612-204-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE ARCHDIOCESE OF ST PAUL AND MPLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "O'REILLY",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "612-204-8387"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699726100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Josephs Community Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.