Allina Health System

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ALLINA HEALTH SYSTEM

Doing business as

Allina Health Greenway Clinic

Practice address

3270 W Lake St
Minneapolis, MN 55416-4512

Phone

(612) 775-1800

Fax

(612) 775-1805

NPI assigned

Jul 26, 2018

Last updated

Feb 25, 2025By 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

Dominica Tallarico

Title

Coo

Phone

(612) 222-2222

Specialties & licenses 2

Addresses

Other names 1

• Allina Health Greenway Clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 31

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.

• Gina Marie Ahlness, APRN ,CNP

  • Adult Health Nurse Practitioner
  • Coon Rapids, MN
  • NPI 1518467760
  NPD
• Greg Alan Andrle, DO

  • Family Medicine Physician
  • Cambridge, MN
  • NPI 1770657884
  NPD
• Amanda Leigh Boozalis, MD

  • Obstetrics & Gynecology Physician
  • Minneapolis, MN
  • NPI 1043701527
  NPD
• Kimberly Renee Cochran, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1336109404
  NPD
• Molly B Gruber, DO

  • Family Medicine Physician
  • Edina, MN
  • NPI 1104323393
  NPD
• Kerry Lynch Guntli, PA-C

  • Medical Physician Assistant
  • Edina, MN
  • NPI 1104177187
  NPD
• Erin Elisabeth Hollom, M.D.

  • Emergency Medicine Physician
  • Maplewood, MN
  • NPI 1568753549
  NPD
• Heidi Huser, MD

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1801826979
  NPD
• Byungkwan Hwang, M.D.

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Minneapolis, MN
  • NPI 1871975672
  NPD
• Subbarao Inampudi, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
  • NPI 1225082829
  NPD
• Todd A Jorgenson, MD

  • Family Medicine Physician
  • Richfield, MN
  • NPI 1710936992
  NPD
• Joshua Ernest Lackner, MD

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1033499306
  NPD

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1649757261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MAIL ROUTE 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": "3270 W LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164512",
            "telephone_number": "612-775-1800",
            "fax_number": "612-775-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "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 Greenway Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allina Health Greenway Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allina Health System
• Allina Health System (Allina Health Non-Hospice Palliative Care)
• Allina Health System (Allina Health Anesthesiologist and CRNA)
• Allina Health System (Allina Health Interventional Radiology Clinic)
• Allina Health System (Allina Health Professional Services)
• Allina Health System (Twin Cities Spine Center)
• Allina Health System (Abbott Northwestern Hospital)
• Allina Health System (Allina Health Laboratory)
• Allina Health System (Allina Health Radiology)
• Allina Health System (Allina Health Piper Building Pharmacy)

• Family Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.