Organization Active NPI

Endgame LLC

  • Clinic/Center
  • Cold Spring, MN
National Provider Identifier
1851116685
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ENDGAME LLC
Practice address
402 Red River Ave N Ste 3
Cold Spring, MN 56320-1523
Phone
(320) 685-8284
Fax
(320) 281-0093
NPI assigned
Nov 18, 2024
Last updated
Nov 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Dr. Lacie Gerhardson, DCNPI 1407832512
Title
Owner
Phone
(320) 224-7069

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

402 Red River Ave N Ste 3
Cold Spring, MN 56320-1523

Mailing address

3508 16TH Ave S
Saint Cloud, MN 56301-4578
Phone (320) 224-7069

National Provider Directory

National Provider Directory

Locations

402 Red River Ave N
Ste 3
Cold Spring, MN 56320
Phone (320) 281-5243

Practitioners & affiliated clinicians

Practitioners 3

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": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1851116685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 16TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014578",
            "telephone_number": "320-224-7069",
            "fax_number": "320-281-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 RED RIVER AVE N STE 3",
            "city": "COLD SPRING",
            "state": "MN",
            "postal_code": "563201523",
            "telephone_number": "320-685-8284",
            "fax_number": "320-281-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDGAME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "GERHARDSON",
        "authorized_official_first_name": "LACIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-224-7069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cold Spring, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.