NPIMap

Organization Active NPI

Mayo Foundation for Medical Education & Research

Doing business as Mayo Clinic Store - Fairmont

  • Durable Medical Equipment & Medical Supplies
  • Fairmont, MN
National Provider Identifier
1821644121
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH
Doing business as
Mayo Clinic Store - Fairmont
Practice address
800 Medical Center Dr Ste 292
Fairmont, MN 56031-4575
Phone
(507) 238-5133
Fax
(507) 238-8674
NPI assigned
Aug 13, 2019
Last updated
Aug 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Dennis Dahlen
Title
Chie Financial Officer
Phone
(507) 284-2511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

800 Medical Center Dr Ste 292
Fairmont, MN 56031-4575

Mailing address

PO Box 861019
Minneapolis, MN 55486-1019
Phone (888) 303-9354

Other names 1

  • Mayo Clinic Store - Fairmont Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200121000537 MN DME Supplier - Medical Supply Company 5890608285 Practice locations: Fairmont, MN

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mayo Clinic Store - Fairmont800 Medical Center Dr, Fairmont, MN 56031-4575(507) 238-5133 Commodes, Urinals, Bedpans|Heat & Cold Applications|Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Walkers|Wheelchair Seating/Cushions|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Ostomy Supplies|Tracheotomy Supplies|Urolo… Does not accept assignmentParticipating since Oct 21, 2003

National Provider Directory

National Provider Directory
Tax ID family
Mayo Medical Resources21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

800 Medical Center Dr
#292
Fairmont, MN 56031
Phone (507) 238-5133

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thorne Crest Retirement CenterAlbert Lea, MN, CCN 245425 Skilled nursing facility Other Mar 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1821644121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 861019",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554861019",
            "telephone_number": "888-303-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR STE 292",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-5133",
            "fax_number": "507-238-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CHIE FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-284-2511"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Store - Fairmont",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mayo Clinic Store - Fairmont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmont, MN

Sources for this page

Verify at the official NPI Registry.