NPIMap

Organization Active NPI

Stepping Stone Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Richfield, MN
National Provider Identifier
1720526759
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
CORP00418 Issued in MN
Legal business name
STEPPING STONE CLINIC, LLC
Practice address
6625 Lyndale Ave S
Suite 500
Richfield, MN 55423-2373
Phone
(612) 886-3704
Fax
(612) 886-3681
NPI assigned
Feb 9, 2017
Last updated
Feb 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Rachelle Hansen, PHD, LPNPI 1487023826
Title
Clinical Director
Phone
(701) 741-7830

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
Multi-Specialty Clinic/Center 261QM1300X CORP00418 MN Primary

Addresses

Primary practice location

6625 Lyndale Ave S
Suite 500
Richfield, MN 55423-2373

Mailing address

5637 Colfax Ave S
Minneapolis, MN 55419-1747
Phone (701) 741-7830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170922003441 MN Part B Supplier - Clinic/Group Practice 1951675321 Receives reassigned benefits from 7 practitioners
Practice locations: Richfield, MN

National Provider Directory

National Provider Directory

Locations

6625 Lyndale Ave S
Ste 500
Richfield, MN 55423
Phone (612) 296-8660

Practitioners & affiliated clinicians

Practitioners 7

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": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1720526759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5637 COLFAX AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191747",
            "telephone_number": "701-741-7830",
            "fax_number": "612-886-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S",
            "address_2": "SUITE 500",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232373",
            "telephone_number": "612-886-3704",
            "fax_number": "612-886-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPPING STONE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "701-741-7830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": "CORP00418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.