NPIMap

Organization Active NPI

Centracare Clinic

  • Community Health Clinic/Center
  • St Cloud, MN
National Provider Identifier
1770020489
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CENTRACARE CLINIC
Practice address
2001 Stockinger Drive
Suite 101
St Cloud, MN 56303
Phone
(320) 251-2700
Fax
(320) 656-7009
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Thomas M Feldhege
Title
Director of Finance and Treasurer
Phone
(320) 240-2152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X MN Primary

Addresses

Primary practice location

2001 Stockinger Drive
Suite 101
St Cloud, MN 56303

Mailing address

1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

Other names 1

  • CentraCare Clinic - Lifestyle Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clearwater Express Care12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1770020489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 STOCKINGER DRIVE",
            "address_2": "SUITE 101",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "FELDHEGE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE AND TREASURER",
        "authorized_official_telephone_number": "320-240-2152"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Clinic - Lifestyle Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Cloud, MN

Sources for this page

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