NPIMap

Organization Active NPI

Amherst H. Wilder Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
National Provider Identifier
1548337355
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
AMHERST H. WILDER FOUNDATION
Practice address
451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone
(651) 280-2000
Fax
(651) 280-2310
NPI assigned
Nov 29, 2006
Last updated
Oct 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Morris Goodwin
Title
Vice President Administration
Phone
(651) 280-2310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

451 Lexington Pkwy N
Saint Paul, MN 55104-4636

Mailing address

451 Lexington Pkwy N
Saint Paul, MN 55104-4636
Phone (651) 280-2310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110526000442 MN Part B Supplier - Clinic/Group Practice 0941288922 Receives reassigned benefits from 83 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory
Tax ID family
Wilder Senior Health CT22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 85

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1548337355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2310",
            "fax_number": "651-280-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LEXINGTON PKWY N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044636",
            "telephone_number": "651-280-2000",
            "fax_number": "651-280-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMHERST H. WILDER FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "VICE PRESIDENT ADMINISTRATION",
        "authorized_official_telephone_number": "651-280-2310"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.