NPIMap

Organization Active NPI

Chaska Medical Center

Doing business as Crossroads Medical Centers, PA

  • Family Medicine Physician
  • Chaska, MN
National Provider Identifier
1518066646
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
153 Issued in MN
Legal business name
CHASKA MEDICAL CENTER
Doing business as
Crossroads Medical Centers, PA
Practice address
3000 N Chestnut St
Suite 120
Chaska, MN 55318-3054
Phone
(952) 448-2050
Fax
(952) 448-2185
NPI assigned
Sep 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John A Rekow
Title
Administrator
Phone
(952) 361-0529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 153 MN Primary

Addresses

Primary practice location

3000 N Chestnut St
Suite 120
Chaska, MN 55318-3054

Mailing address

3000 N Chestnut St
Suite 120
Chaska, MN 55318-3054
Phone (952) 448-2050

Other identifiers 1

IdentifierTypeStateIssuer
51172CHOtherMNMN BCBS ID NUMBER

Other names 1

  • Crossroads Medical Centers, PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chaska Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518066646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N CHESTNUT ST",
            "address_2": "SUITE 120",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553183054",
            "telephone_number": "952-448-2050",
            "fax_number": "952-448-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N CHESTNUT ST",
            "address_2": "SUITE 120",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553183054",
            "telephone_number": "952-448-2050",
            "fax_number": "952-448-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASKA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REKOW",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "952-361-0529"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BCBS ID NUMBER",
            "identifier": "51172CH",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Medical Centers, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.