Fergus Falls Medical Group, P.a.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

44 Issued in MN

Legal business name

FERGUS FALLS MEDICAL GROUP, P.A.

Practice address

405 Main St
Ashby, MN 56309-4659

Phone

(218) 747-2293

Fax

(218) 747-2294

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Jim Wilkus

Title

Ceo

Phone

(218) 739-2221

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ashby Clinic Other name

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134167166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S MILL ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372756",
            "telephone_number": "218-739-2221",
            "fax_number": "218-739-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "ASHBY",
            "state": "MN",
            "postal_code": "563094659",
            "telephone_number": "218-747-2293",
            "fax_number": "218-747-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERGUS FALLS MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKUS",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-739-2221"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AC MEDICA #",
            "identifier": "00-01587",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AC UCARE #",
            "identifier": "126702",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AC BCBS #",
            "identifier": "62345FE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashby Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashby Holdings, LLC
• Ashby Living Center Inc.
• Terra L Berglund
• Foundation for Rural Health Care
• Ind School Dist 261
• Haley Marie Ness
• Purpose Home Healthcare
• Village of Ashby

• Multi-Specialty Clinic/Center in Ashby, MN
• Providers in Ashby, MN by specialty
• Multi-Specialty Clinic/Center in Minnesota

• 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.