NPIMap

Organization Active NPI

Gillette Children'S Specialty Healthcare

  • Prosthetic/Orthotic Supplier
  • Crookston, MN
National Provider Identifier
1457747172
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Practice address
323 S Minnesota St
Crookston, MN 56716-1601
Phone
(651) 634-1938
NPI assigned
Apr 9, 2015
Organization subpart
Yes
Parent organization
GILLETTE CHILDREN'S SPECIALTY HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Authorized official

Name
James L Haddican
Title
VP of Finance/Cfo
Phone
(651) 312-3105

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

323 S Minnesota St
Crookston, MN 56716-1601

Mailing address

200 University Ave E
Patient Accounting Dept 2ND Floor, 435 Phalen
Saint Paul, MN 55101-2507
Phone (651) 325-2177

National Provider Directory

National Provider Directory
Tax ID family
Gillette Childrens Hosp13 organizations share this tax ID, including this one
Part of
Gillette Childrens Hosp

Other organizations with this tax ID 12

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": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1457747172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "address_2": "PATIENT ACCOUNTING DEPT 2ND FLOOR, 435 PHALEN",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-325-2177",
            "fax_number": "651-325-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "651-634-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLETTE CHILDREN'S SPECIALTY HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GILLETTE CHILDREN'S SPECIALTY HEALTHCARE",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "HADDICAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP OF FINANCE/CFO",
        "authorized_official_telephone_number": "651-312-3105"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.