Allina Health System
Organization Active NPI Clinic/Center · Shakopee, MN
NPI 1477859486 · NPPES record last updated Jan 23, 2025
Key facts
- NPI
- 1477859486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ALLINA HEALTH SYSTEM
- Practice address
- 1601 St Francis Ave
Ste 100
Shakopee, MN 55379-3387 - Phone
- (952) 428-3535
- Fax
- (952) 428-3599
- NPI assigned
- Feb 9, 2011
- Organization subpart
- No
Authorized official
- Name
- Dominica Tallarico
- Title
- Coo
- Phone
- (612) 222-2222
Practitioners 65
-
Munir Abid, MD
-
Dana Marie Bakke, PA-C
-
Jeffrey Frederik Ballard, PA-C
-
Julie Brisco, LP
-
Nicole S Burkette Ikebata, MD, MPH
-
Morgan Butler, AU.D.
-
Mary L Cameron, MD
-
Madeline Rose Carchedi, PA-C
-
Justine M Chatterton, PHD LP
-
Alfredmy G Chessor, M.D.
-
Erin Kristine Church, LICSW
-
Sharon Kay Eriksen, CNRN, CNP
-
Shari Ann Fahey, PA-C
-
Michael Shane Farrell, D.O.
-
David Gregory Fine, M.D.
-
Julie Goldfine, DNP
-
Christopher WH Hall, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MN
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| St Francis Regional Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (47.5%) | Nov 15, 2007 |
| Courage Kenny Rehabilitation Institute TRP |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jun 1, 2013 Jun 1, 2013 |
| Allina Health Restorative Suites |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Nov 10, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
| O20120302000287 | MN | DME Supplier - Physician - Unknown Physician Specialty | 4587573613 | Practice locations: Shakopee, MN |
| O20221213001713 | MN | Part B Supplier - Clinic/Group Practice | 4587573613 |
Receives reassigned benefits from 3,000 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
1601 St Francis Ave
Ste 100
Shakopee, MN 55379-3387
Mailing address
PO Box 43
Mail Route 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166
Other names
- Allina Health Shakopee Clinic
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 Shakopee, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.