McCornell Court

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

346068 Issued in MN

Legal business name

MCCORNELL COURT

Practice address

122 No. McCornell Avenue
Parkers Prairie, MN 56361

Phone

(218) 338-4671

Fax

(218) 338-5917

NPI assigned

Dec 15, 2009

Organization subpart

Yes

Parent organization

ST. WILLIAMS LIVING CENTERAs reported in NPPES

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

Authorized official

Name

Mr. Paul C. Baer

Title

Administrator

Phone

(218) 338-4671

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

McCornell Court2 organizations share this tax ID, including this one

Part of

McCornell Court

Other organizations with this tax ID 1

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

• St. William'S Living Center

  • Assisted Living Facility
  • Henning, MN
  • NPI 1659126894
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dianne Verant

  • Clinical Social Worker
  • Parkers Prairie, MN
  • NPI 1760642029
  NPD (past)

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1700115003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 30",
            "city": "PARKERS PRAIRIE",
            "state": "MN",
            "postal_code": "56361",
            "telephone_number": "218-338-4671",
            "fax_number": "218-338-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NO. MCCORNELL AVENUE",
            "city": "PARKERS PRAIRIE",
            "state": "MN",
            "postal_code": "56361",
            "telephone_number": "218-338-4671",
            "fax_number": "218-338-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORNELL COURT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. WILLIAMS LIVING CENTER",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "BAER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-338-4671",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "346068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887342900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Solien Hartmann, FNP-C
• Klemek Chiropractic
• Jillian Klemek, D.C.
• Donna M Krull
• Claudia A. Liljegren, MSW
• Parkers Prairie Community Ambulance
• Casey Larae Ruckheim, NCTMB
• Sanford Clinic North
• St. William'S Living Center
• Rachel Elizabeth Stanchfield, PA-C

• Assisted Living Facility in Parkers Prairie, MN
• Providers in Parkers Prairie, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.