NPIMap

Individual provider Active NPI

Christina Stavig, DO

  • Family Medicine Physician
  • Bloomington, MN
National Provider Identifier
1447424882
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50985 Issued in MN
Practice address
5320 Hyland Greens Dr
Park Nicollet Clinic - Bloomington
Bloomington, MN 55437-3938
Phone
(952) 993-2400
Fax
(952) 993-2522
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50985 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5320 Hyland Greens Dr
Park Nicollet Clinic - Bloomington
Bloomington, MN 55437-3938

Mailing address

5320 Hyland Greens Dr
Park Nicollet Clinic - Bloomington
Bloomington, MN 55437-3938
Phone (952) 993-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080926000110 MN Practitioner - Family Practice 9830266287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8455 Flying Cloud Dr
Eden Prairie, MN 55344-3974
Phone (952) 993-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
50985MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Sep 13, 2010 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Interoperability endpoints

  • Direct secure messaging: cstavig156778@direct.healthpartners.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1447424882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 HYLAND GREENS DR",
            "address_2": "PARK NICOLLET CLINIC - BLOOMINGTON",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373938",
            "telephone_number": "952-993-2400",
            "fax_number": "952-993-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 HYLAND GREENS DR",
            "address_2": "PARK NICOLLET CLINIC - BLOOMINGTON",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373938",
            "telephone_number": "952-993-2400",
            "fax_number": "952-993-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVIG",
        "first_name": "CHRISTINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50985",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.