Active NPI
Fairview Clinics
Doing business as Fairview Clinics-Bass Lake
- Primary Care Clinic/Center
- Maple Grove, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- FAIRVIEW CLINICS
- Doing business as
- Fairview Clinics-Bass Lake
- Practice address
- 6320 Wedgewood Rd N
Maple Grove, MN 55311-3647 - Phone
- (763) 268-0400
- Fax
- (763) 268-0405
- NPI assigned
- Aug 16, 2007
- Last updated
- Feb 28, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maureen V Ring
- Title
- Sys Dir Govt Reimb & Netwk Rel
- Phone
- (612) 672-6740
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
6320 Wedgewood Rd N
Maple Grove, MN 55311-3647
Mailing address
1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740
Other names 1
- Fairview Clinics-Bass Lake
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031106000516 | MN | Part B Supplier - Clinic/Group Practice | 7113830142 |
Receives reassigned benefits from 2,406 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D1058229 | Fairview Clinics Bass Lake Clinic | Accreditation | Jun 23, 2028 |
National Provider Directory
National Provider DirectoryLocations
14040 Northdale Blvd
Ste 10
Rogers, MN 55374
Phone (763) 241-5870
1151 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (612) 706-4500
Practitioners & affiliated clinicians
Practitioners 69
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.
-
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- Minneapolis, MN
- NPI 1861810129
-
- Family Medicine Physician
- Oakdale, MN
- NPI 1437134541
-
- Pediatrics Physician
- Saint Paul, MN
- NPI 1790195923
-
- Pediatric Adolescent Medicine Physician
- Andover, MN
- NPI 1376775437
-
- Physician Assistant
- Roseville, MN
- NPI 1831680313
-
- Pediatrics Physician
- Bloomington, MN
- NPI 1659563765
-
- Pediatrics Physician
- Crookston, MN
- NPI 1508030396
-
- Surgery Physician
- Princeton, MN
- NPI 1063775260
-
- Family Nurse Practitioner
- Wyoming, MN
- NPI 1609802453
-
- Physician Assistant
- Edina, MN
- NPI 1811185325
-
- Nuclear Radiology Physician
- Minneapolis, MN
- NPI 1447414024
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1134156359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740700800000",
"number": "1790977486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551043727",
"telephone_number": "612-672-6740",
"fax_number": "612-884-3592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 WEDGEWOOD RD N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553113647",
"telephone_number": "763-268-0400",
"fax_number": "763-268-0405"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRVIEW CLINICS",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-16",
"last_updated": "2025-02-28",
"certification_date": "2025-02-28",
"status": "A",
"authorized_official_last_name": "RING",
"authorized_official_first_name": "MAUREEN",
"authorized_official_middle_name": "V",
"authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
"authorized_official_telephone_number": "612-672-6740"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fairview Clinics-Bass Lake",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Fairview Clinics-Bass Lake",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Maple Grove, MN
- Terry L Evers, APNP
- Renata R Evertz, D.C.
- Hannah Mathilde Evju
- Amanda Exman, PSY.D., LP
- Gina Fabiano, LAC
- Fairview Clinics (Fairview Clinics-Maple Grove)
- Fairview Express Care
- Fairview Maple Grove Surgery Center, LLC
- Fairview Maple Grove Surgery Center, LLC
- Fairview Pharmacy Services LLC (Fairview Maple Grove Clinic MTM)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.