Organization Active NPI

Crescenterra Health Center, PA

  • Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1659509180
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1853 Issued in MN
Legal business name
CRESCENTERRA HEALTH CENTER, PA
Practice address
245 Prior Ave N
Saint Paul, MN 55104-5163
Phone
(651) 917-3990
Fax
(651) 917-3922
NPI assigned
Jun 23, 2009
Last updated
Jun 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Authorized official

Name
Mary E Rutherford, DCNPI 1043598436
Title
President
Phone
(651) 917-3990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 1853 MN Primary

Addresses

Primary practice location

245 Prior Ave N
Saint Paul, MN 55104-5163

Mailing address

245 Prior Ave N
Saint Paul, MN 55104-5163
Phone (651) 917-3990

National Provider Directory

National Provider Directory

Locations

245 Prior Ave N
Saint Paul, MN 55104
Phone (612) 598-1305

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1659509180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PRIOR AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045163",
            "telephone_number": "651-917-3990",
            "fax_number": "651-917-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PRIOR AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045163",
            "telephone_number": "651-917-3990",
            "fax_number": "651-917-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENTERRA HEALTH CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "RUTHERFORD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-917-3990",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "1853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.