NPIMap

Organization Active NPI

Healtheast Care System

Doing business as HealthEast - Oakdale Clinic

  • Non-Pharmacy Dispensing Site
  • Oakdale, MN
National Provider Identifier
1669514493
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
27012 Issued in MN
Legal business name
HEALTHEAST CARE SYSTEM
Doing business as
HealthEast - Oakdale Clinic
Practice address
1099 Helmo Ave N
Suite 100
Oakdale, MN 55128-6033
Phone
(651) 326-5300
NPI assigned
Feb 12, 2007
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Mr. Scott Peterson
Title
Cfo
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 27012 MN Primary

Addresses

Primary practice location

1099 Helmo Ave N
Suite 100
Oakdale, MN 55128-6033

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701
Phone (858) 625-2990

Other names 1

  • HealthEast - Oakdale Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healtheast Gallery Int6 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 5

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

Locations

1099 Helmo Ave N
Ste 100
Saint Paul, MN 55128
Phone (651) 326-5300

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1669514493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 HELMO AVE N",
            "address_2": "SUITE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286033",
            "telephone_number": "651-326-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHEAST CARE SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-12",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "858-625-2990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MN",
            "license": "27012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthEast - Oakdale Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.