Allina Health System
Organization Active NPI Maternal & Fetal Medicine Physician · Coon Rapids, MN
NPI 1447527767 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1447527767
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Maternal & Fetal Medicine Physician 207VM0101X
- Legal business name
- ALLINA HEALTH SYSTEM
- Practice address
- 3960 Coon Rapids Blvd NW Ste 220
Coon Rapids, MN 55433-2589 - Phone
- (763) 236-8438
- NPI assigned
- Dec 1, 2011
- Organization subpart
- No
Authorized official
- Name
- Dominica Tallarico
- Title
- Coo
- Phone
- (612) 222-2222
Owners & managing parties with NPI records 1
-
Daniel Thomas O'Laughlin, M.D.
Other NPIs on the same Medicare enrollment 7
Related certifications (CCN) 1
Practitioners 30
-
Derek James Anderst, M.D.
-
Odette C El Helou, M.D.
-
Miriam Leah Fishman, PSY.D.
-
Laura Suurmeyer Gusa, M.D.
-
Christa Nicole Heckman, PA-C, MPAS
-
Anne M Hendrickson, PA-C
-
Natalie Nicole Johnson, APRN, CNP
-
Chester Mulholland, LPCC
-
Jeffrey John Olson, M.D.
-
Kathleen Ann Otremba, DNP APRN CNP
-
Avery Rose Schalla, PA-C
-
Eiman Shafa, M.D.
-
Sapana Shakya, FNP
-
Sneha Shukla, MD
-
Jennifer Marie Vulaj, M.D.
Affiliated clinicians 1,274
-
David Aamodt, MD
-
Mohamad Y Abbas, M.D.
-
Tess Abrahamson, PA-C
-
Obinna E. Agujiobi, M.D.
-
Suresh Ahanya, MD
-
Gina Marie Ahlness, APRN ,CNP
-
Aqeel Ahmad, M.D.
-
Abdelwahaab Akef, M.D.
-
Laila Summer Akhter, DNP, APRN, FNP-C
-
Joseph W. Akornor, M.D.
-
Javid Akram, MD
-
Jayasri Alapati, MD
-
Siobhan Esther Alexander, M.D.
-
Azhar T. Ali, MBBS
-
Uzma Ali, MBBS
Medicare Care Compare: Hospital
- Listed as
- Mercy Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Hospital certification: CCN 240115
- Legal name
- ALLINA HEALTH SYSTEM
- Doing business as
- MERCY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 1, 1970
- Last certification
- Nov 29, 2012
- Beds
- 573 (546 certified)
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- May 1, 1987 (2 total)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 27
| Name | Role | Since | Share |
|---|---|---|---|
| Challis Lowe |
Corporate Director | Jun 8, 2022 | |
| John Richard Church |
Corporate Director |
Sep 9, 2021 | |
| Laura Jean Gillund |
Corporate Director |
Jun 10, 2015 | |
| Amy L Ronneberg |
Corporate Director |
Dec 1, 2020 | |
| Daniel Thomas O'Laughlin |
Corporate Director |
Jan 1, 2022 | |
| Maykao Y Hang |
Corporate Director |
Jun 13, 2019 | |
| David Allan Joos |
Corporate Officer |
Oct 1, 2025 | |
| Brian McGrane |
Corporate Director |
Jun 14, 2024 | |
| Marna Borgstrom |
Corporate Director |
Jun 13, 2025 | |
| Kelly J Spratt |
Corporate Officer |
Dec 27, 2025 | |
| Jennifer Soo Alstad |
Corporate Director |
Jun 10, 2016 | |
| Shari L Ballard |
Corporate Director |
Jun 10, 2020 | |
| Timothy Aloysius Welsh |
Corporate Director |
Dec 1, 2017 | |
| Vicki Rasmusen |
Corporate Director |
Jun 13, 2019 | |
| Debbra Schoneman |
Corporate Director |
Jun 13, 2013 | |
| James Kolar |
Corporate Director |
Sep 13, 2024 | |
| Lisa Shannon |
Corporate Director |
Jan 1, 2022 | |
| Shawn M Ulreich |
Corporate Director |
Sep 13, 2023 | |
| Chanda L Baker |
Corporate Director |
Feb 20, 2024 | |
| Melinda Estes |
Corporate Director |
Jun 13, 2025 | |
| Louis Julius King |
Corporate Director |
Jun 12, 2017 | |
| Ruth Evelyn Williams-Brinkley |
Corporate Director |
Sep 13, 2023 | |
| Patricia W Schirmers |
Corporate Director | May 6, 2003 | |
| Barbara a Butts Williams |
Corporate Director |
Jun 10, 2015 | |
| Thomas S Schreier |
Corporate Director |
Mar 12, 2014 | |
| Dominica Marie Tallarico |
Corporate Officer |
Mar 11, 2024 | |
| Roger Scott Newcome |
Corporate Director |
May 6, 2016 | |
| W-2 Managing Employee |
May 6, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030506000004 | MN | Part a Provider - Hospital | 4587573613 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fridley, MN; Coon Rapids, MN; Cambridge, MN; Buffalo, MN |
| O20040319000460 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 4,246 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
280 Smith Ave N
Ste 450
Saint Paul, MN 55102
Phone (651) 241-5959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician |
207VM0101X | Yes | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
3960 Coon Rapids Blvd NW Ste 220
Coon Rapids, MN 55433-2589
Mailing address
2925 Chicago Ave
Route 10585
Minneapolis, MN 55407-1321
Phone (612) 262-1166
Other names
- Minnesota Perinatal Physicians - Mercy
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service | Other | Ciox Health |
Other providers in Coon Rapids, MN
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
- Allina Health System
All providers in Coon Rapids, MN · Maternal & Fetal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.