Organization Active NPI

Northern Integrated Health, Inc.

  • Addiction Psychiatry Physician
  • St Louis Park, MN
National Provider Identifier
1831413442
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
35122 Issued in MN
Legal business name
NORTHERN INTEGRATED HEALTH, INC.
Practice address
6200 Excelsior Blvd
Suite 202
St Louis Park, MN 55416-2730
Phone
(952) 548-9340
NPI assigned
Mar 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Authorized official

Name
Ms. Lois Cochrane SchlutterNPI 1396839684
Title
Psychologist
Phone
(952) 548-9340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X 35122 MN Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 24280 MN

Addresses

Primary practice location

6200 Excelsior Blvd
Suite 202
St Louis Park, MN 55416-2730

Mailing address

6200 Excelsior Blvd
Suite 202
St Louis Park, MN 55416-2730
Phone (952) 548-9340

Other identifiers 1

IdentifierTypeStateIssuer
063225200MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250805002895 MN Part B Supplier - Clinic/Group Practice 0244750651 Receives reassigned benefits from 1 practitioner
Practice locations: St Louis Park, MN

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1831413442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 EXCELSIOR BLVD",
            "address_2": "SUITE 202",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162730",
            "telephone_number": "952-548-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 EXCELSIOR BLVD",
            "address_2": "SUITE 202",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162730",
            "telephone_number": "952-548-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INTEGRATED HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "SCHLUTTER",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "COCHRANE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "952-548-9340",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MN",
            "license": "35122",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MN",
            "license": "24280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063225200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.