Organization Active NPI

Firstsolutions

Doing business as SuperiorHealth Center

  • Clinic/Center
  • Proctor, MN
National Provider Identifier
1902833874
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FIRSTSOLUTIONS
Doing business as
SuperiorHealth Center
Practice address
211 S Boundary Ave
Proctor, MN 55810-2306
Phone
(218) 624-4819
Fax
(218) 624-7323
NPI assigned
Jun 27, 2006
Last updated
May 14, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRSTSOLUTIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2010

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

Authorized official

Name
Mr. Terry R Jacobson
Title
Ceo
Phone
(218) 740-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

211 S Boundary Ave
Proctor, MN 55810-2306

Mailing address

211 S Boundary Ave
Proctor, MN 55810-2306
Phone (218) 624-4819

Other identifiers 1

IdentifierTypeStateIssuer
558210500MedicaidMN

Other names 1

  • SuperiorHealth Center Doing business as

National Provider Directory

National Provider Directory
Part of
First Plan of Minnesota

Locations

4621 E Superior St
Duluth, MN 55804
Phone (218) 786-3550

2202 E 2nd St
Ste 377
Superior, WI 54880
Phone (715) 817-7990

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1902833874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S BOUNDARY AVE",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102306",
            "telephone_number": "218-624-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S BOUNDARY AVE",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102306",
            "telephone_number": "218-624-4819",
            "fax_number": "218-624-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRSTSOLUTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRSTSOLUTIONS",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-740-2330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558210500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SuperiorHealth Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Proctor, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.