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Organization Active NPI

Pipestone County Medical Center

Doing business as Pipestone Family Clinic

  • Family Medicine Physician
  • Pipestone, MN
National Provider Identifier
1073576906
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2569527 Issued in MN
Legal business name
PIPESTONE COUNTY MEDICAL CENTER
Doing business as
Pipestone Family Clinic
Practice address
916 4TH Ave SW
Pipestone, MN 56164-1890
Phone
(507) 825-5700
Fax
(507) 825-4752
NPI assigned
Apr 11, 2006
Last updated
Aug 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Mr. Bradley Burris
Title
Hospital Administrator
Phone
(507) 825-5811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2569527 MN Primary
Surgery Physician 208600000X 2569527 MN

Addresses

Primary practice location

916 4TH Ave SW
Pipestone, MN 56164-1890

Mailing address

916 4TH Ave SW
Pipestone, MN 56164-1890
Phone (507) 825-5700

Other identifiers 2

IdentifierTypeStateIssuer
149723500MedicaidMN
2569527OtherMNMINNESOTA STATE LICENSE

Other names 1

  • Pipestone Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000578 MN Part B Supplier - Clinic/Group Practice 0840109682 Receives reassigned benefits from 79 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edgerton, MN; Pipestone, MN; Slayton, MN
O20250709003362 SD Part B Supplier - Clinic/Group Practice 0840109682 Receives reassigned benefits from 1 practitioner
Practice locations: Flandreau, SD

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avera@Home PipestonePipestone, MN, CCN 241580 Hospice Operational/Managerial Control Dec 12, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 77

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.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1073576906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 4TH AVE SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561641890",
            "telephone_number": "507-825-5700",
            "fax_number": "507-825-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 4TH AVE SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561641890",
            "telephone_number": "507-825-5700",
            "fax_number": "507-825-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIPESTONE COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "507-825-5811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "2569527",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "2569527",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149723500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA STATE LICENSE",
            "identifier": "2569527",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pipestone Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pipestone Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pipestone, MN

Sources for this page

Verify at the official NPI Registry.