NPIMap

Organization Active NPI

St Mary's Regional Health Center

Doing business as Essentia Health- Lincoln Park

  • Assisted Living Facility
  • Detroit Lakes, MN
National Provider Identifier
1437290335
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
333475 Issued in MN
Legal business name
ST MARY'S REGIONAL HEALTH CENTER
Doing business as
Essentia Health- Lincoln Park
Practice address
208 Oak Street
Detroit Lakes, MN 56501
Phone
(218) 847-0894
Fax
(218) 847-1895
NPI assigned
Feb 12, 2007
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ESSENTIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Alan James Hurley
Title
Coo
Phone
(979) 820-4247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 333475 MN Primary

Addresses

Primary practice location

208 Oak Street
Detroit Lakes, MN 56501

Mailing address

208 Oak Street
Detroit Lakes, MN 56501
Phone (218) 847-0894

Other identifiers 1

IdentifierTypeStateIssuer
480075000MedicaidMN

Other names 1

  • Essentia Health- Lincoln Park Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2235490Essentia Health St Mary's Lincoln Park208 Oak Street, Detroit Lakes, MN 56501Certificate of waiverSep 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Marys Regional Healt11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1437290335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 OAK STREET",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "56501",
            "telephone_number": "218-847-0894",
            "fax_number": "218-847-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OAK STREET",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "56501",
            "telephone_number": "218-847-0894",
            "fax_number": "218-847-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S REGIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESSENTIA HEALTH",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "979-820-4247"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "333475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480075000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health- Lincoln Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health- Lincoln Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.