Ecumen

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

332717 Issued in MN

Legal business name

ECUMEN

Doing business as

dba Bayshore Health Center

Practice address

1601 Saint Louis Ave
Duluth, MN 55802-2442

Phone

(218) 727-8651

NPI assigned

Feb 5, 2007

Last updated

Mar 17, 2010By 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

Ms. Kathryn R Roberts

Title

Ceo,President

Phone

(651) 766-4313

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• dba Bayshore Health Center Doing business as

Tax ID family

Bayshore Duluth Management LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bayshore Duluth Management, LLC

  • Skilled Nursing Facility
  • Duluth, MN
  • NPI 1104265644
  NPD tax ID

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1326187642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SAINT LOUIS AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022442",
            "telephone_number": "218-727-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SAINT LOUIS AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022442",
            "telephone_number": "218-727-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECUMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO,PRESIDENT",
        "authorized_official_telephone_number": "651-766-4313",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "332717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "411768508",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST MARY HOSPICE",
            "identifier": "411768508",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5G48BA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122550",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183488600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0506",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "90160",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Bayshore Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison R Eckman, DPT
• Matthew Jay Eckman
• Brigette Eckwood
• David Bruce Economy
• Ecumen (Ecumen Lakeshore)
• Ecumen (Ecumen Lakeshore Transportation)
• Ecumen (Ecumen Duluth The Shores)
• Ecumen (Bayshore Health Center)
• Ecumen (Ecumen Home Care - Lakeshore)
• Bradley Edgerton

• Skilled Nursing Facility in Duluth, MN
• Providers in Duluth, 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 Mar 17, 2010; 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.