NPIMap

Organization Active NPI

The Duluth Clinic LTD

Doing business as Essentia Health Orthopedic Urgent Care

  • Urgent Care Clinic/Center
  • Duluth, MN
National Provider Identifier
1902459209
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
THE DULUTH CLINIC LTD
Doing business as
Essentia Health Orthopedic Urgent Care
Practice address
1301 Miller Trunk Hwy Ste 400
Duluth, MN 55811-5639
Phone
(218) 576-0680
Fax
(218) 576-0690
NPI assigned
Jul 17, 2019
Last updated
Jul 17, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. MARY'S DULUTH CLINIC HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Kevin Boren
Title
VP Finance
Phone
(218) 786-1009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1301 Miller Trunk Hwy Ste 400
Duluth, MN 55811-5639

Mailing address

1301 Miller Trunk Hwy Ste 400
Duluth, MN 55811-5639
Phone (218) 576-0680

Other names 1

  • Essentia Health Orthopedic Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000229 MN Part B Supplier - Clinic/Group Practice 2567374283 Receives reassigned benefits from 1,610 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Part of
St Marys Duluth Clinic Health System

Locations

1301 Miller Trunk Hwy
Ste 400
Duluth, MN 55811
Phone (218) 249-6839

Practitioners & affiliated clinicians

Practitioners 145

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 145

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1902459209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MILLER TRUNK HWY STE 400",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115639",
            "telephone_number": "218-576-0680",
            "fax_number": "218-576-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MILLER TRUNK HWY STE 400",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115639",
            "telephone_number": "218-576-0680",
            "fax_number": "218-576-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DULUTH CLINIC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S DULUTH CLINIC HEALTH SYSTEM",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "BOREN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "218-786-1009"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Orthopedic Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.