NPIMap

Organization Active NPI

St. Mary's Regional Health Center

Doing business as St. Mary's Nursing Center DME

  • Durable Medical Equipment & Medical Supplies
  • Detroit Lakes, MN
National Provider Identifier
1104988229
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
332297 Issued in MN
Legal business name
ST. MARY'S REGIONAL HEALTH CENTER
Doing business as
St. Mary's Nursing Center DME
Practice address
1040 Lincoln Ave
Detroit Lakes, MN 56501-3508
Phone
(218) 847-0820
Fax
(218) 844-0780
NPI assigned
Dec 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christy Brinkman III
Title
Administrator
Phone
(218) 847-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 332297 MN Primary

Addresses

Primary practice location

1040 Lincoln Ave
Detroit Lakes, MN 56501-3508

Mailing address

1040 Lincoln Ave
Detroit Lakes, MN 56501-3508
Phone (218) 847-0820

Other identifiers 5

IdentifierTypeStateIssuer
1A755MAOtherMNBLUE CROSS BLUE SHIELD MN
30393OtherMNNORTH DAKOTA MEDICAID
1041862OtherMNPREFERRED ONE
623840800MedicaidMN
7122625OtherMNMEDICA

Other names 1

  • St. Mary's Nursing Center DME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Marys Regional Healt11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104988229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 LINCOLN AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013508",
            "telephone_number": "218-847-0820",
            "fax_number": "218-844-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 LINCOLN AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013508",
            "telephone_number": "218-847-0820",
            "fax_number": "218-844-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-847-0700",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "332297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "1A755MA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA MEDICAID",
            "identifier": "30393",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1041862",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623840800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122625",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Nursing Center DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.