NPIMap

Organization Active NPI

Allina Health System

Doing business as Allina Health Mental Health - Mercy Hospital, Unity Campus

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fridley, MN
National Provider Identifier
1598700528
Registry record updated Feb 24, 2025
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
ALLINA HEALTH SYSTEM
Doing business as
Allina Health Mental Health - Mercy Hospital, Unity Campus
Practice address
520 Osborne Rd NE Ste 210
Fridley, MN 55432-2718
Phone
(763) 236-3800
NPI assigned
Jun 16, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Dominica Tallarico
Title
Coo
Phone
(612) 222-2222

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Psychologist 103T00000X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

520 Osborne Rd NE Ste 210
Fridley, MN 55432-2718

Mailing address

PO Box 43
Mr 10585
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

16927 35th Dr SE
Bothell, WA 98012-5484
Phone (763) 236-3800

Other names 1

  • Allina Health Mental Health - Mercy Hospital, Unity Campus Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030506000004 MN Part A Provider - Hospital 4587573613 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fridley, MN; Coon Rapids, MN; Cambridge, MN; Buffalo, MN
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598700528. Details of each certification follow.

Hospital certification: CCN 240115

Legal name
ALLINA HEALTH SYSTEM
Doing business as
MERCY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 1, 1970
Last certification
Nov 29, 2012
Beds
573 (546 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
May 1, 1987 (2 total)
Organization structure
CorporationNon-profit
Enrollment address
4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy HospitalCCN 240115 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

480 Osborne Rd NE
Ste 260
Minneapolis, MN 55432
Phone (763) 236-3800

Ownership & related parties

All disclosed owners & managing parties 27

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Challis Lowe Individual Corporate Director Jun 8, 2022
John Richard Church Individual Corporate DirectorBoard Member Sep 9, 2021
Laura Jean Gillund Individual Corporate DirectorBoard Member Jun 10, 2015
Amy L Ronneberg Individual Corporate DirectorBoard Member Dec 1, 2020
Daniel Thomas O'Laughlin Individual Corporate DirectorBoard Member Jan 1, 2022
Maykao Y Hang Individual Corporate DirectorBoard Member Jun 13, 2019
David Allan Joos Individual Corporate OfficerSenior VP Oct 1, 2025
Brian McGrane Individual Corporate DirectorBoard Member Jun 14, 2024
Marna Borgstrom Individual Corporate DirectorBoard Member Jun 13, 2025
Kelly J Spratt Individual Corporate OfficerPresident Dec 27, 2025
Jennifer Soo Alstad Individual Corporate DirectorBoard Member Jun 10, 2016
Shari L Ballard Individual Corporate DirectorBoard Member Jun 10, 2020
Timothy Aloysius Welsh Individual Corporate DirectorBoard Member Dec 1, 2017
Vicki Rasmusen Individual Corporate DirectorBoard Member Jun 13, 2019
Debbra Schoneman Individual Corporate DirectorBoard Member Jun 13, 2013
James Kolar Individual Corporate DirectorBoard Member Sep 13, 2024
Lisa Shannon Individual Corporate DirectorPresident and Ceo Jan 1, 2022
Shawn M Ulreich Individual Corporate DirectorBoard Member Sep 13, 2023
Chanda L Baker Individual Corporate DirectorBoard Member Feb 20, 2024
Melinda Estes Individual Corporate DirectorBoard Member Jun 13, 2025
Louis Julius King Individual Corporate DirectorBoard Member Jun 12, 2017
Ruth Evelyn Williams-Brinkley Individual Corporate DirectorBoard Member Sep 13, 2023
Patricia W Schirmers Individual Corporate Director May 6, 2003
Barbara a Butts Williams Individual Corporate DirectorBoard Member Jun 10, 2015
Thomas S Schreier Individual Corporate DirectorBoard Member Mar 12, 2014
Dominica Marie Tallarico Individual Corporate OfficerCoo Mar 11, 2024
Roger Scott Newcome Individual Corporate DirectorManager May 6, 2016
W-2 Managing EmployeeManager May 6, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 21

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 21

Affiliated clinicians 1,273

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,273

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1598700528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 10585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 OSBORNE RD NE STE 210",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322718",
            "telephone_number": "763-236-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16927 35th Dr SE",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980125484",
            "country_code": "US",
            "telephone_number": "763-236-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "TALLARICO",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "612-222-2222"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allina Health Mental Health - Mercy Hospital, Unity Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allina Health Mental Health - Mercy Hospital, Unity Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.