NPIMap

Organization Active NPI

Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Alexandria, MN
National Provider Identifier
1588050280
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Practice address
1500 Irving St
Alexandria, MN 56308-0046
Phone
(320) 762-6085
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 Jun 6, 2025

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

Authorized official

Name
Patrick Nolan
Title
Cfo
Phone
(651) 312-3105

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1500 Irving St
Alexandria, MN 56308-0046

Mailing address

200 University Ave E
Saint Paul, MN 55101-2507
Phone (651) 291-2848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000485 MN Part B Supplier - Clinic/Group Practice 0547169211 Receives reassigned benefits from 310 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Willmar, MN; Saint Paul, MN; Saint Cloud, MN; Maple Grove, MN; Duluth, MN; Burnsville, MN; Bemidji, MN; Baxter, MN…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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.

Locations

1500 Irving St
Alexandria, MN 56308
Phone (320) 762-0857

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1749168000000",
    "number": "1588050280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012507",
            "telephone_number": "651-291-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 IRVING ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563080046",
            "telephone_number": "320-762-6085"
        }
    ],
    "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": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-312-3105"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.