The College of St Scholastica

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R1113747 Issued in MN

Legal business name

THE COLLEGE OF ST SCHOLASTICA

Practice address

1200 Kenwood Ave
Duluth, MN 55811-4199

Phone

(218) 723-6282

Fax

(218) 723-5953

NPI assigned

May 16, 2008

Organization subpart

No

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

Authorized official

Name

Tad Sears

Title

Director Schwb

Phone

(218) 723-6017

Specialties & licenses 1

Addresses

Other names 1

• Student Health Service Other name

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

Student Health Service2 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.

• The College of St. Scholastica

  • Nurse Practitioner
  • Duluth, MN
  • NPI 1992864821
  NPD tax ID

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1902063027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 KENWOOD AVE",
            "address_2": "STUDENT HEALTH SERVICE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114199",
            "telephone_number": "218-723-6282",
            "fax_number": "218-723-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 KENWOOD AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114199",
            "telephone_number": "218-723-6282",
            "fax_number": "218-723-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COLLEGE OF ST SCHOLASTICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "SEARS",
        "authorized_official_first_name": "TAD",
        "authorized_official_title_or_position": "DIRECTOR SCHWB",
        "authorized_official_telephone_number": "218-723-6017"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R1113747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Health Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shane Michael Tetzlaff, D.D.S.
• Megan Elizabeth Tezak, MSW, LICSW
• Nongnut Thao
• Jenni Anne Tharaldson, CNP
• Katie Jo Thayer, OTR/L
• The College of St. Scholastica
• The Dental Specialist of Minnesota, PLLC
• The Duluth Clinic LTD
• The Duluth Clinic LTD
• The Duluth Clinic LTD

• Family Nurse Practitioner in Duluth, MN
• Providers in Duluth, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.