NPIMap

Organization Active NPI

Open Door Health Center

  • Federally Qualified Health Center (FQHC)
  • Mankato, MN
National Provider Identifier
1356611404
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPEN DOOR HEALTH CENTER
Practice address
309 Holly LN
Mankato, MN 56001-5422
Phone
(507) 388-2120
Fax
(507) 388-3924
NPI assigned
Jan 6, 2012
Last updated
Apr 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Authorized official

Name
Mr. Douglas L Jaeger Jr.
Title
Ceo
Phone
(507) 344-5500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

309 Holly LN
Mankato, MN 56001-5422

Mailing address

309 Holly LN
Mankato, MN 56001-5422
Phone (507) 388-2120

Other names 1

  • Open Door Health Center - Mobile Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Open Door Health Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1356611404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120",
            "fax_number": "507-388-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HOLLY LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015422",
            "telephone_number": "507-388-2120",
            "fax_number": "507-388-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-344-5500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Door Health Center - Mobile Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.