County of Isanti

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

COUNTY OF ISANTI

Doing business as

Isanti County Public Health

Practice address

555 18TH Ave SW
Cambridge, MN 55008

Phone

(763) 689-4071

Fax

(763) 689-8293

NPI assigned

Sep 15, 2006

Last updated

Apr 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Glenn Buttacavoli

Title

CHS Administrator/ Director

Phone

(763) 689-8284

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Isanti County Public Health Doing business as

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

CLIA laboratory certificates

Tax ID family

County of Isanti2 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.

• Isanti County Family Services

  • Case Management Agency
  • Cambridge, MN
  • NPI 1568691376
  NPD tax ID

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1851497309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 18TH AVE SW",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "55008",
            "telephone_number": "763-689-4071",
            "fax_number": "763-689-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 18TH AVE SW",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "55008",
            "telephone_number": "763-689-4071",
            "fax_number": "763-689-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ISANTI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "BUTTACAVOLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CHS ADMINISTRATOR/ DIRECTOR",
        "authorized_official_telephone_number": "763-689-8284",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1025957",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8220IS",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "116467",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399853300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G633IF",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "8300061",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G633IS",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Isanti County Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lissa Cisneros, DDS
• Faith Lynn Combel
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• Sandra Maureen Connell, OD
• Corner Medical LLC (Corner Home Medical)
• Rebecca Crain, LPCC
• Angelique Ann Creger, OT
• Dakota Communities Inc
• Denise Dalske
• Sharon Ann Davalos, PT

• Public Health or Welfare Agency in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Public Health or Welfare Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.