NPIMap

Organization Active NPI

Centracare Health-Paynesville LLC

Doing business as CentraCare Health - Paynesville Washburne Court

  • Assisted Living Facility
  • Paynesville, MN
National Provider Identifier
1457788994
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
CENTRACARE HEALTH-PAYNESVILLE LLC
Doing business as
CentraCare Health - Paynesville Washburne Court
Practice address
311 Washburne Ave
Paynesville, MN 56362-1658
Phone
(320) 243-7451
NPI assigned
Sep 30, 2013
Last updated
Oct 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Mr. Michael A. Blair
Title
Sr. Vice President and Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

311 Washburne Ave
Paynesville, MN 56362-1658

Mailing address

200 W 1St St
Paynesville, MN 56362-1445
Phone (320) 243-3767

Other names 1

  • CentraCare Health - Paynesville Washburne Court Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centracare Health-Paynesville LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1457788994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767",
            "fax_number": "320-243-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WASHBURNE AVE",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621658",
            "telephone_number": "320-243-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE HEALTH-PAYNESVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "320-255-5665",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Health - Paynesville Washburne Court",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CentraCare Health - Paynesville Washburne Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paynesville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.