NPIMap

Organization Active NPI

Centracare Clinic

Doing business as CentraCare - Cold Spring Clinic

  • Primary Care Clinic/Center
  • Cold Spring, MN
National Provider Identifier
1881116747
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CENTRACARE CLINIC
Doing business as
CentraCare - Cold Spring Clinic
Practice address
402 Red River Ave N Ste 2
Cold Spring, MN 56320-1523
Phone
(320) 685-8641
Fax
(320) 685-4020
NPI assigned
Jul 12, 2017
Last updated
Sep 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRACARE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Michael A Blair
Title
Sr VP & Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

402 Red River Ave N Ste 2
Cold Spring, MN 56320-1523

Mailing address

PO Box 735818
Chicago, IL 60673-5818
Phone (320) 252-5131

Other names 1

  • CentraCare - Cold Spring Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000293 MN Part B Supplier - Clinic/Group Practice 2466363395 Receives reassigned benefits from 1,127 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0405902Centracare Cold Spring402 N Red River Ave #2, Cold Spring, MN 56320AccreditationDec 22, 2027

National Provider Directory

National Provider Directory
Part of
Altru Clinic

Member of 1

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

Locations

1900 Centracare Cir
Ste 1340
Sartell, MN 56303
Phone (320) 229-5105

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1881116747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735818",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735818",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 RED RIVER AVE N STE 2",
            "city": "COLD SPRING",
            "state": "MN",
            "postal_code": "563201523",
            "telephone_number": "320-685-8641",
            "fax_number": "320-685-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRACARE CLINIC",
        "enumeration_date": "2017-07-12",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VP & CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare - Cold Spring Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.