NPIMap

Organization Active NPI

Prairie Island Indian Community

Doing business as Prairie Island Community Clinic

  • Clinic/Center
  • Welch, MN
National Provider Identifier
1821305129
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRAIRIE ISLAND INDIAN COMMUNITY
Doing business as
Prairie Island Community Clinic
Practice address
1158 Island Blvd
Welch, MN 55089-9540
Phone
(651) 385-4148
Fax
(651) 385-4170
NPI assigned
Sep 8, 2010
Last updated
Sep 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Victoria Winfrey
Title
Tribal Council President
Phone
(651) 385-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1158 Island Blvd
Welch, MN 55089-9540

Mailing address

1158 Island Blvd
Welch, MN 55089-9540
Phone (651) 385-4148

Other names 1

  • Prairie Island Community Clinic Doing business as

National Provider Directory

National Provider Directory

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": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1821305129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 ISLAND BLVD",
            "city": "WELCH",
            "state": "MN",
            "postal_code": "550899540",
            "telephone_number": "651-385-4148",
            "fax_number": "651-385-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 ISLAND BLVD",
            "city": "WELCH",
            "state": "MN",
            "postal_code": "550899540",
            "telephone_number": "651-385-4148",
            "fax_number": "651-385-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE ISLAND INDIAN COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "WINFREY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "TRIBAL COUNCIL PRESIDENT",
        "authorized_official_telephone_number": "651-385-4105"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairie Island Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Welch, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.