425 N Badger Street Caledonia Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

425 N BADGER STREET CALEDONIA OPCO LLC

Practice address

425 N Badger St
Caledonia, MN 55921

Phone

(507) 725-3351

NPI assigned

Jun 25, 2018

Last updated

Jun 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Myers

Title

Manager

Phone

(507) 725-3351

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1194210997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N BADGER ST",
            "city": "CALEDONIA",
            "state": "MN",
            "postal_code": "559211567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N BADGER ST",
            "city": "CALEDONIA",
            "state": "MN",
            "postal_code": "55921",
            "telephone_number": "507-725-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "425 N BADGER STREET CALEDONIA OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "507-725-3351"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 425 N Badger Street Caledonia Opco LLC
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• Kristin Ann Buege, D.C.
• Erich Burt

• Skilled Nursing Facility in Caledonia, MN
• Providers in Caledonia, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.