South

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTH

Practice address

717 S State St
Ste 1000
Fairmont, MN 56031-4469

Phone

(507) 235-3939

NPI assigned

May 17, 2016

Organization subpart

No

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

Authorized official

Name

Corey T Welchlin, DONPI 1649241977

Title

Owner President

Phone

(507) 238-4949

Specialties & licenses 1

Addresses

Other names 1

• Fairmont ASC Doing business as

Tax ID family

Fairmont Orthopedics PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fairmont Orthopedics & Sports Medicine P a

  • Durable Medical Equipment & Medical Supplies
  • Fairmont, MN
  • NPI 1437486479
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corey T Welchlin, D.O.

  • Orthopaedic Surgery Physician
  • Macomb, IL
  • NPI 1649241977
  NPD (past) Authorized official

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1114374469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST",
            "address_2": "STE 1000",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314469",
            "telephone_number": "507-235-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "WELCHLIN",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "507-238-4949",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairmont ASC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairmont ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Jo Smith, PHARMD
• SMSS PLLC
• Timothy Snelson, MD
• Sara Lorraine Snyder
• Sonny'S Taxi
• South Central Surgical Center, LLC
• Southern Plains Education Cooperative
• Carly Steier
• Kaylynn R Steinkamp, PA
• Jasmine Stephan, PHARMD

• Ambulatory Surgical Clinic/Center in Fairmont, MN
• Providers in Fairmont, MN by specialty
• Ambulatory Surgical Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.