NPIMap

Organization Active NPI

Altru Health System

  • Family Medicine Physician
  • Erskine, MN
National Provider Identifier
1083189203
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALTRU HEALTH SYSTEM
Practice address
23076 347TH Street SE
Erskine, MN 56535-9466
Phone
(952) 653-2565
Fax
(952) 653-2540
NPI assigned
Oct 4, 2018
Reactivated
Nov 13, 2019
Last updated
Aug 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Douglas Arvin
Title
Cfo
Phone
(701) 780-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

23076 347TH Street SE
Erskine, MN 56535-9466

Mailing address

23076 347TH St SE
Erskine, MN 56535-9466
Phone (952) 653-2565

National Provider Directory

National Provider Directory
Tax ID family
Physicians Associates M24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1083189203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23076 347TH ST SE",
            "city": "ERSKINE",
            "state": "MN",
            "postal_code": "565359466",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23076 347TH STREET SE",
            "city": "ERSKINE",
            "state": "MN",
            "postal_code": "565359466",
            "telephone_number": "952-653-2565",
            "fax_number": "952-653-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTRU HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "deactivation_date": "2019-08-07",
        "reactivation_date": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "ARVIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-780-5000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erskine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.