NPIMap

Organization Active NPI

Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
National Provider Identifier
1619448685
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HENNEPIN COUNTY
Practice address
165 Glenwood Ave
Minneapolis, MN 55405-1618
Phone
(612) 348-5553
Fax
(612) 677-6299
NPI assigned
Dec 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Stephanie Abel
Title
Area Manager
Phone
(612) 348-8824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

165 Glenwood Ave
Minneapolis, MN 55405-1618

Mailing address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 348-5553

Other names 1

  • Catholic Charities, Higher Ground Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040218001012 MN Part B Supplier - Clinic/Group Practice 7911892849 Receives reassigned benefits from 194 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Minneapolis, MN
O20190205001680 MN Part A Provider - Federally Qualified Health Center (FQHC) 7911892849 Practice locations: Minneapolis, MN

Federally qualified health center certification: CCN 241880

Legal name
HENNEPIN COUNTY
Doing business as
CATHOLIC CHARITIES HIGHER GROUND
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 7, 2019
Last certification
Jan 7, 2019
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Sep 19, 1989 in MN
Enrollment address
165 Glenwood Ave
Minneapolis, MN 55405-1618

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Hennepin County Medical Ctr26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Elizabeth David Individual Corporate DirectorDeputy County Administrator - Healt Jun 1, 2018 100%
Hennepin County Organization, Minneapolis, MN 5% Or Greater Direct Ownership Interest Sep 19, 1987 100%
Stephanie Abel Individual W-2 Managing EmployeeArea Manager Jun 1, 2018 100%
Bao Vang Individual Corporate OfficerSenior Administrative Manager Jul 1, 2022 100%
W-2 Managing EmployeeSenior Administrative Manager Jul 1, 2022 100%

Owners & managing parties with NPI records 14

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

View all 14

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hennepin County Medical CenterMinneapolis, MN, CCN 240004 Hospital Operational/Managerial Control (100%) Nov 29, 2006
Hennepin County Medical CenterMinneapolis, MN, CCN 24T004 Hospital Operational/Managerial Control (100%) Nov 29, 2006
Hennepin County Medical CenterMinneapolis, MN, CCN 24S004 Hospital Operational/Managerial Control (100%) Nov 29, 2006
MvnaMinneapolis, MN, CCN 247008 Home health agency Operational/Managerial Control (100%) Nov 29, 2006
Hennepin CountyMinneapolis, MN, CCN 241801 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 1990
Northpoint Health & Wellness CenterMinneapolis, MN, CCN 241861 Federally qualified health center Operational/Managerial Control Nov 2, 2010
Northpoint Pyc ClinicMinneapolis, MN, CCN 241862 Federally qualified health center Operational/Managerial Control Nov 2, 2010
Northpoint Olson Middle SchoolMinneapolis, MN, CCN 241869 Federally qualified health center Operational/Managerial Control Sep 1, 2014
Northpoint Workforce Center ClinicMinneapolis, MN, CCN 241873 Federally qualified health center Other (100%) Jan 1, 1968
Northpoint Franklin Middle SchoolMinneapolis, MN, CCN 241877 Federally qualified health center Other (100%) Jan 1, 1968
People Serving PeopleMinneapolis, MN, CCN 241885 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 19, 1987
Sep 19, 1987
YouthlinkMinneapolis, MN, CCN 241879 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 19, 1987
Sep 19, 1977
Salvation Army Harbor Light CenterMinneapolis, MN, CCN 241881 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 19, 1987
EndeavorsMinneapolis, MN, CCN 241899 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 19, 1987
Sep 19, 1987

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

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": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1619448685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 GLENWOOD AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051618",
            "telephone_number": "612-348-5553",
            "fax_number": "612-677-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNEPIN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "ABEL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "AREA MANAGER",
        "authorized_official_telephone_number": "612-348-8824"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Charities, Higher Ground",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.