NPIMap

Organization Active NPI

Green Pine Acres

  • Home Health Agency
  • Menahga, MN
National Provider Identifier
1699838029
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
331360 Issued in MN
Legal business name
GREEN PINE ACRES
Practice address
427 Main St NE
Menahga, MN 56464-8702
Phone
(218) 564-4101
Fax
(218) 564-5309
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mr. Clair E Erickson
Title
Administrator
Phone
(218) 564-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 331360 MN Primary

Addresses

Primary practice location

427 Main St NE
Menahga, MN 56464-8702

Mailing address

427 Main St NE
Menahga, MN 56464-8702
Phone (218) 564-4101

Other identifiers 2

IdentifierTypeStateIssuer
812524400MedicaidMN
4980316OtherFMMEDICA

Other names 1

  • MENAHGA HOME HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Green Pine Acres2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1699838029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 MAIN ST NE",
            "city": "MENAHGA",
            "state": "MN",
            "postal_code": "564648702",
            "telephone_number": "218-564-4101",
            "fax_number": "218-564-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 MAIN ST NE",
            "city": "MENAHGA",
            "state": "MN",
            "postal_code": "564648702",
            "telephone_number": "218-564-4101",
            "fax_number": "218-564-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PINE ACRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "CLAIR",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-564-4101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "331360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812524400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4980316",
            "state": "FM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MENAHGA HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Menahga, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.