NPIMap

Organization Active NPI

Fairview Clinics

Doing business as Fairview Clinics-Rush City

  • Primary Care Clinic/Center
  • Rush City, MN
National Provider Identifier
1295989457
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FAIRVIEW CLINICS
Doing business as
Fairview Clinics-Rush City
M Health Fairview Clinic - Rush City
Practice address
760 W 4TH St
Rush City, MN 55069-9063
Phone
(320) 358-4784
Fax
(320) 358-4665
NPI assigned
Nov 13, 2008
Last updated
Oct 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Robert Andrew McCoy
Title
VP Revenue Management
Phone
(612) 672-6594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

760 W 4TH St
Rush City, MN 55069-9063

Mailing address

PO Box 9372
Minneapolis, MN 55440-9372
Phone (612) 672-6724

Other names 2

  • Fairview Clinics-Rush City Doing business as
  • M Health Fairview Clinic - Rush City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000516 MN Part B Supplier - Clinic/Group Practice 7113830142 Receives reassigned benefits from 2,406 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Fairview Clinics23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1295989457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9372",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554409372",
            "telephone_number": "612-672-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W 4TH ST",
            "city": "RUSH CITY",
            "state": "MN",
            "postal_code": "550699063",
            "telephone_number": "320-358-4784",
            "fax_number": "320-358-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "VP REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "612-672-6594"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Clinics-Rush City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Fairview Clinic - Rush City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rush City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.