Individual provider Active NPI

Christine Lynn Gedicke, LICSW

  • Clinical Social Worker
  • Owatonna, MN
National Provider Identifier
1881133403
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19514 Issued in MN
Practice address
2250 NW 26TH St
Owatonna, MN 55060-5503
Phone
(507) 977-2574
Fax
(507) 977-2373
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19514 MN Primary

Addresses

Primary practice location

2250 NW 26TH St
Owatonna, MN 55060-5503

Mailing address

2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 977-2574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220608001190 MN Practitioner - Clinical Social Worker 3577941210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jul 15, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jul 15, 2022 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850

Interoperability endpoints

  • Direct secure messaging: cgedicke302603@excellian.direct.allina.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1881133403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-977-2574",
            "fax_number": "507-977-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-977-2574",
            "fax_number": "507-977-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDICKE",
        "first_name": "CHRISTINE",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.