Isd 763 Medford Public School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

ISD 763 MEDFORD PUBLIC SCHOOL

Practice address

750 2ND Ave SE
Medford, MN 55049-9586

Phone

(507) 451-5250

Fax

(507) 451-6474

NPI assigned

Jan 3, 2007

Organization subpart

No

Name

Gary Braun

Title

Special Education Coordinator

Phone

(507) 451-5250

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2008.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1245397603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 2ND AVE SE",
            "city": "MEDFORD",
            "state": "MN",
            "postal_code": "550499586",
            "telephone_number": "507-451-5250",
            "fax_number": "507-451-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 2ND AVE SE",
            "city": "MEDFORD",
            "state": "MN",
            "postal_code": "550499586",
            "telephone_number": "507-451-5250",
            "fax_number": "507-451-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISD 763 MEDFORD PUBLIC SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "SPECIAL EDUCATION COORDINATOR",
        "authorized_official_telephone_number": "507-451-5250"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "901405500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Medford, MN
• Local Education Agency (LEA) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.