NPIMap

Organization Active NPI

Minnesota State College and Universities

  • Athletic Trainer
  • Mankato, MN
National Provider Identifier
1366949141
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Legal business name
MINNESOTA STATE COLLEGE AND UNIVERSITIES
Practice address
135 Myers Field House
Mankato, MN 56001
Phone
(507) 389-5461
Fax
(507) 389-5352
NPI assigned
Apr 9, 2018
Last updated
Apr 9, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MINNESOTA STATE COLLEGES AND UNIVERSITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Authorized official

Name
Mr. Richard John Straka, MBA, CPA (EXECUTIVE)
Title
VP for Finance & Admin
Phone
(507) 389-6621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X NU Primary

Addresses

Primary practice location

135 Myers Field House
Mankato, MN 56001

Mailing address

135 Myers Field House
Mankato, MN 56001
Phone (507) 389-5461

Other practice location 1

135 Myers Field House
Mankato, MN 56001
Phone (507) 389-5461

National Provider Directory

National Provider Directory
Tax ID family
Minnesota State Colleges Universities27 organizations share this tax ID, including this one
Part of
Minnesota State Colleges Universities

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1366949141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MYERS FIELD HOUSE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-389-5461",
            "fax_number": "507-389-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 MYERS FIELD HOUSE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-389-5461",
            "fax_number": "507-389-5352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Myers Field House",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "56001",
            "country_code": "US",
            "telephone_number": "507-389-5461",
            "fax_number": "507-389-5352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINNESOTA STATE COLLEGE AND UNIVERSITIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA STATE COLLEGES AND UNIVERSITIES",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "STRAKA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VP FOR FINANCE & ADMIN",
        "authorized_official_telephone_number": "507-389-6621",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CPA (EXECUTIVE)"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 9, 2018; 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.