NPIMap

Organization Active NPI

Prairie St. Johns

  • Children's Hospital
  • Minnetonka, MN
National Provider Identifier
1235260993
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
14993 Issued in MN
Legal business name
PRAIRIE ST. JOHNS
Practice address
11610 Wayzata Blvd
Minnetonka, MN 55305-2009
Phone
(952) 230-9180
NPI assigned
Mar 7, 2007
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
Ms. Gina Kinnamon
Title
Executive Assistant
Phone
(701) 476-7208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 14993 MN Primary

Addresses

Primary practice location

11610 Wayzata Blvd
Minnetonka, MN 55305-2009

Mailing address

110 W Grant St Apt 9J
Minneapolis, MN 55403-2311
Phone (612) 940-1546

National Provider Directory

National Provider Directory
Tax ID family
Prairie St John'S Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235260993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W GRANT ST APT 9J",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032311",
            "telephone_number": "612-940-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11610 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052009",
            "telephone_number": "952-230-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE ST. JOHNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KINNAMON",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "701-476-7208",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "MN",
            "license": "14993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, 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.