NPIMap

Organization Active NPI

St Marys Regional Health Center

Doing business as Essentia Health Park Rapids Hwy 34 Clinic

  • Multi-Specialty Clinic/Center
  • Park Rapids, MN
National Provider Identifier
1730731464
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ST MARYS REGIONAL HEALTH CENTER
Doing business as
Essentia Health Park Rapids Hwy 34 Clinic
Practice address
1103 1St St E
Park Rapids, MN 56470
Phone
(218) 732-6300
Fax
(218) 732-6370
NPI assigned
Jul 12, 2019
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ST MARYS REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Ryan Hill
Title
Cfo
Phone
(218) 314-7852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1103 1St St E
Park Rapids, MN 56470

Mailing address

1702 University Dr S
Medical Staff Services-SSC
Fargo, ND 58103-4940
Phone (701) 364-4222

Other names 1

  • Essentia Health Park Rapids Hwy 34 Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000090 MN Part B Supplier - Clinic/Group Practice 2062326820 Receives reassigned benefits from 290 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frazee, MN; Lake Park, MN; Mahnomen, MN; Menahga, MN; Park Rapids, MN; Pelican Rapids, MN; Walker, MN; Detroit Lakes, MN

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
St Marys Regional Healt11 organizations share this tax ID, including this one
Part of
St Marys Regional Healt

Other organizations with this tax ID 10

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 84

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.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1730731464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "address_2": "MEDICAL STAFF SERVICES-SSC",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 1ST ST E",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "56470",
            "telephone_number": "218-732-6300",
            "fax_number": "218-732-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS REGIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARYS REGIONAL HEALTH CENTER",
        "enumeration_date": "2019-07-12",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-314-7852"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Park Rapids Hwy 34 Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health Park Rapids Hwy 34 Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.