NPIMap

Organization Active NPI

Essentia Health Virginia, LLC

Doing business as Essentia Health International Falls Clinic

  • Multi-Specialty Clinic/Center
  • International Falls, MN
National Provider Identifier
1386682045
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ESSENTIA HEALTH VIRGINIA, LLC
Doing business as
Essentia Health International Falls Clinic
Practice address
2501 Keenan Dr
International Falls, MN 56649-2181
Phone
(218) 283-9431
NPI assigned
Jun 3, 2006
Last updated
Jan 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SMDC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Steven Feltman
Title
Cfo
Phone
(218) 742-8662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

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 1

  • Essentia Health International Falls Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
St Mary's Duluth Clinic Health System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

300 W Conan St
Ely, MN 55731
Phone (218) 365-7900

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

2501 Keenan Dr
Intl Falls, MN 56649
Phone (218) 283-4481

1625 Maple Ln
Ashland, WI 54806
Phone (715) 682-9311

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1386682045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-283-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-283-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIA HEALTH VIRGINIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMDC HEALTH SYSTEM",
        "enumeration_date": "2006-06-03",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "FELTMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-742-8662"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health International Falls Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health International Falls Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in International Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.