Crow Wing & Cass Cos Ind School Dist No 186

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

CROW WING & CASS COS IND SCHOOL DIST NO 186

Practice address

30805 Olson St
Pequot Lakes, MN 56472-3094

Phone

(218) 568-4996

NPI assigned

Oct 5, 2006

Last updated

Nov 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wanda Lane

Title

Third Party Administrator

Phone

(218) 454-5532

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1629164504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 OAK STREET",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "56401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30805 OLSON ST",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564723094",
            "telephone_number": "218-568-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROW WING & CASS COS IND SCHOOL DIST NO 186",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "218-454-5532"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487463300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Local Education Agency (LEA) in Pequot Lakes, MN
• Providers in Pequot Lakes, MN by specialty
• Local Education Agency (LEA) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.