Essentia Health Virginia, LLC
Organization Active NPI Multi-Specialty Clinic/Center · International Falls, MN
NPI 1386682045 · NPPES record last updated Jan 16, 2019
Key facts
- NPI
- 1386682045
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- ESSENTIA HEALTH VIRGINIA, LLC
- Practice address
- 2501 Keenan Dr
International Falls, MN 56649-2181 - Phone
- (218) 283-9431
- NPI assigned
- Jun 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SMDC HEALTH SYSTEM
Authorized official
- Name
- Steven Feltman
- Title
- Cfo
- Phone
- (218) 742-8662
Other NPIs on the same Medicare enrollment 26
Member of 2
Practitioners 56
-
Lisa Anne Arvold, M.D.
-
Tyler Adam Ferrell, M.D.
-
Diana Elizabeth Harvey, RN, CNP
-
Aaron James Hegg, MD
-
Thomas James Heinitz, M.D.
-
Nha P Nguyen, MD
-
Darci Leigh Pelland, RN, CNP
-
Paul Rasmussen, RN, CNP
-
Kimberly Salo, RN, CNP
-
Amber Marie Biondich, APRN, CNP
-
Kristina Marie Britton, M.D.
-
Nicole Marie Busch, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000229 | MN | Part B Supplier - Clinic/Group Practice | 2567374283 |
Receives reassigned benefits from 1,610 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
| O20130306000467 | MN | Part B Supplier - Clinic/Group Practice | 7810149002 |
Receives reassigned benefits from 193 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Babbitt, MN; Ely, MN; International Falls, MN; Virginia, MN |
National Provider Directory
- Part of
- St Marys Duluth Clinic Health System
Locations
910 N 6th Ave
Virginia, MN 55792
Phone (218) 741-0150
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
2501 Keenan Dr
International Falls, MN 56649-2181
Mailing address
2501 Keenan Dr
International Falls, MN 56649-2181
Phone (218) 283-9431
Other names
- Essentia Health International Falls Clinic
Other providers in International Falls, MN
- Samantha Ann Crossley
- Jacelyn Paige Davidson
- Bonita Lynn Despain
- Whitney Lee Donner
- E L Anderson City Drug Store
- Essentia Health Virginia, LLC
- Falls Advanced Chiropractic Center
- Falls Chiropractic Clinic, LTD
- Falls Medical Group, PLLC
- Ralinda Ellen Ferguson
All providers in International Falls, MN · Multi-Specialty Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.