NPIMap

Organization Active NPI

Red Wing Health Center

  • Psychologist
  • Red Wing, MN
National Provider Identifier
1841617172
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
RED WING HEALTH CENTER
Practice address
1412 W 4TH St
Red Wing, MN 55066-2107
Phone
(651) 385-4804
Fax
(651) 385-0967
NPI assigned
Mar 25, 2014
Last updated
Mar 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Shelly Holmstadt
Title
Business Office Director
Phone
(651) 385-4804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1412 W 4TH St
Red Wing, MN 55066-2107

Mailing address

1412 W 4TH St
Red Wing, MN 55066-2107
Phone (651) 385-4804

National Provider Directory

National Provider Directory
Tax ID family
Red Wing Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1841617172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 W 4TH ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662107",
            "telephone_number": "651-385-4804",
            "fax_number": "651-385-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 W 4TH ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662107",
            "telephone_number": "651-385-4804",
            "fax_number": "651-385-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WING HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "HOLMSTADT",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "651-385-4804"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.