NPIMap

Organization Active NPI

Centracare Health System

Doing business as CentraCare Health Community Paramedic

  • Clinic/Center
  • Saint Cloud, MN
National Provider Identifier
1083164255
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CENTRACARE HEALTH SYSTEM
Doing business as
CentraCare Health Community Paramedic
Practice address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone
(320) 251-2700
Fax
(320) 255-5711
NPI assigned
Oct 11, 2016
Last updated
Apr 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Authorized official

Name
Gregory R Klugherz
Title
Vice President and Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1406 6TH Ave N
Saint Cloud, MN 56303-1900

Mailing address

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other identifiers 2

IdentifierTypeStateIssuer
6900009424OtherMNRR MEDICARE
443985600MedicaidMN

Other names 1

  • CentraCare Health Community Paramedic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centracare Health System5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1083164255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-255-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-255-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "KLUGHERZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "6900009424",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443985600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Health Community Paramedic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.