NPIMap

Organization Active NPI

Omada, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Northfield, MN
National Provider Identifier
1396780946
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1023523-2-CDT Issued in MN
Legal business name
OMADA, INC.
Practice address
401 Division St S
Suite a
Northfield, MN 55057-2095
Phone
(507) 664-9407
Fax
(507) 664-3862
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Carolyn B Green, CPA
Title
Business Manager
Phone
(507) 664-9407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1023523-2-CDT MN Primary

Addresses

Primary practice location

401 Division St S
Suite a
Northfield, MN 55057-2095

Mailing address

401 Division St S
Suite a
Northfield, MN 55057-2095
Phone (507) 664-9407

Other identifiers 6

IdentifierTypeStateIssuer
173158OtherUCARE
5045989OtherMEDICA/UBH
91167OtherHEALTHPARTNERS
2H51OMOtherBCBS
124611OtherMMSI
1032951OtherPREFERRED ONE

Other names 1

  • Omada Behavioral Health Services Doing business as

National Provider Directory

National Provider Directory

Locations

401 Division St S
Ste A
Northfield, MN 55057
Phone (507) 664-9407

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396780946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DIVISION ST S",
            "address_2": "SUITE A",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572095",
            "telephone_number": "507-664-9407",
            "fax_number": "507-664-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DIVISION ST S",
            "address_2": "SUITE A",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572095",
            "telephone_number": "507-664-9407",
            "fax_number": "507-664-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMADA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "507-664-9407",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1023523-2-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "173158",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA/UBH",
            "identifier": "5045989",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "91167",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2H51OM",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMSI",
            "identifier": "124611",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1032951",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omada Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.