NPIMap

Organization Active NPI

Hiawatha Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1215573209
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HIAWATHA SURGERY CENTER LLC
Doing business as
Greenway Surgery Center
Practice address
2020 E 28TH St Ste 100
Minneapolis, MN 55407-1453
Phone
(612) 728-7000
Fax
(612) 728-2660
NPI assigned
Nov 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Amistyene Brincefield
Title
Administrator
Phone
(612) 728-2668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2020 E 28TH St Ste 100
Minneapolis, MN 55407-1453

Mailing address

9205 Woodland Dr
Minnetrista, MN 55375-4516
Phone (763) 464-1611

Other names 1

  • Greenway Surgery Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1215573209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 WOODLAND DR",
            "city": "MINNETRISTA",
            "state": "MN",
            "postal_code": "553754516",
            "telephone_number": "763-464-1611",
            "fax_number": "612-728-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 28TH ST STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071453",
            "telephone_number": "612-728-7000",
            "fax_number": "612-728-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIAWATHA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "BRINCEFIELD",
        "authorized_official_first_name": "AMISTYENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-728-2668"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenway Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.