Organization Active NPI

City of Woodbury

  • Land Ambulance
  • Woodbury, MN
National Provider Identifier
1790855641
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
MN-0275 Issued in MN
Legal business name
CITY OF WOODBURY
Practice address
2100 Radio Dr
Woodbury, MN 55125-9598
Phone
(651) 714-3500
Fax
(651) 714-3501
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Clinton Gridley
Title
City Administrator
Phone
(651) 714-3521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X MN-0275 MN Primary

Addresses

Primary practice location

2100 Radio Dr
Woodbury, MN 55125-9598

Mailing address

8301 Valley Creek Rd
Woodbury, MN 55125-2320
Phone (651) 714-3500

Other identifiers 4

IdentifierTypeStateIssuer
7G268CIOtherMNBC BS OF MN
81-82027OtherMNMEDICA
111581OtherMNUCARE
036858001MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100204000546 MN Part B Supplier - Ambulance Service Supplier 4486797099 Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Locations

1275 Woodbury Dr
Woodbury, MN 55129
Phone (651) 714-3600

2100 Radio Dr
Woodbury, MN 55125
Phone (651) 714-3500

8301 Valley Creek Rd
Woodbury, MN 55125

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1790855641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 VALLEY CREEK RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252320",
            "telephone_number": "651-714-3500",
            "fax_number": "651-714-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259598",
            "telephone_number": "651-714-3500",
            "fax_number": "651-714-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF WOODBURY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "GRIDLEY",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "CITY ADMINISTRATOR",
        "authorized_official_telephone_number": "651-714-3521"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MN",
            "license": "MN-0275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MN",
            "identifier": "7G268CI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "81-82027",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "111581",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036858001",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.