NPIMap

Organization Active NPI

Allina Health System

Doing business as Allina Health River Falls Clinic

  • General Practice Physician
  • River Falls, WI
National Provider Identifier
1407395247
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ALLINA HEALTH SYSTEM
Doing business as
Allina Health River Falls Clinic
Practice address
1617 E Division St
River Falls, WI 54022-1571
Phone
(715) 307-6600
NPI assigned
Feb 13, 2017
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Dominica Tallarico
Title
Coo
Phone
(612) 222-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1617 E Division St
River Falls, WI 54022-1571

Mailing address

PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other names 1

  • Allina Health River Falls Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031218000417 WI Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 522 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baldwin, WI; River Falls, WI; Grantsburg, WI; Prescott, WI
O20180210000180 WI DME Supplier - Multi-Specialty - Physician 4587573613 Practice locations: River Falls, WI
O20221214000269 WI Part B Supplier - Clinic/Group Practice 4587573613 Receives reassigned benefits from 308 practitioners
1 other NPI on this enrollment
Practice locations: River Falls, WI

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Francis Regional Medical CenterShakopee, MN, CCN 240104 Hospital 5% Or Greater Direct Ownership Interest (47.5%) Nov 15, 2007
Courage Kenny Rehabilitation Institute TRPGolden Valley, MN, CCN 245519 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 1, 2013
Jun 1, 2013
Allina Health Restorative SuitesPlymouth, MN, CCN 245624 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 10, 2022

Practitioners & affiliated clinicians

Practitioners 331

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 331

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1407395247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MAIL ROUTE 10585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "715-307-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "TALLARICO",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "612-222-2222"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allina Health River Falls Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allina Health River Falls Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in River Falls, WI

Sources for this page

Verify at the official NPI Registry.