MBH-MN Medical Clinic PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MBH-MN MEDICAL CLINIC PA

Practice address

550 Main St Ste 260
New Brighton, MN 55112-3273

Phone

(612) 326-7558

NPI assigned

Jul 30, 2018

Last updated

Aug 30, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bud Lile, MD

Title

Owner/Medical Director

Phone

(612) 232-7558

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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.

• Maria Laina Berg, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Olivia, MN
  • NPI 1558834143
  NPD (past)
• Kelsie Jean Fuoss, BA, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Redwood Falls, MN
  • NPI 1982177838
  NPD (past)
• Ernest William Lampe, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Minneapolis, MN
  • NPI 1023062783
  NPD (past)
• Matthew Jon Thorson, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Minnetonka, MN
  • NPI 1811469653
  NPD (past)

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1922586270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST # 190",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551123271",
            "telephone_number": "612-454-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAIN ST STE 260",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551123273",
            "telephone_number": "612-326-7558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 Estes Ave SW",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "MN",
            "postal_code": "553908432",
            "country_code": "US",
            "telephone_number": "763-658-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2480 S County Road 45",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "550605113",
            "country_code": "US",
            "telephone_number": "612-454-2130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3329 University Ave SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554143325",
            "country_code": "US",
            "telephone_number": "612-454-2340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2807 Brookdale Dr",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554441844",
            "country_code": "US",
            "telephone_number": "763-237-9898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6043 Hudson Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251033",
            "country_code": "US",
            "telephone_number": "651-925-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Brainerd",
            "state": "MN",
            "postal_code": "564015549",
            "country_code": "US",
            "telephone_number": "218-454-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3470 Washington Dr Ste 165",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551223517",
            "country_code": "US",
            "telephone_number": "651-454-2833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1821 University Ave W Ste 385",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551042872",
            "country_code": "US",
            "telephone_number": "651-647-0095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11900 Wayzata Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553052018",
            "country_code": "US",
            "telephone_number": "612-454-2102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1825 Curve Crest Blvd W Ste 103",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826054",
            "country_code": "US",
            "telephone_number": "651-351-9325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Sunrise Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Saint Peter",
            "state": "MN",
            "postal_code": "560821353",
            "country_code": "US",
            "telephone_number": "507-931-0918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19230 Evans St NW Ste 203",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553301574",
            "country_code": "US",
            "telephone_number": "612-248-1455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Olivia",
            "state": "MN",
            "postal_code": "562771589",
            "country_code": "US",
            "telephone_number": "320-400-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1680 Airport Rd N",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "MN",
            "postal_code": "561873500",
            "country_code": "US",
            "telephone_number": "507-376-3916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 N Holcombe Ave",
            "address_purpose": "LOCATION",
            "city": "Litchfield",
            "state": "MN",
            "postal_code": "553552210",
            "country_code": "US",
            "telephone_number": "320-693-2461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 N Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "MN",
            "postal_code": "553905517",
            "country_code": "US",
            "telephone_number": "763-658-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 Colorado St E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551072244",
            "country_code": "US",
            "telephone_number": "651-489-7740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17305 Meadow Creek Lane",
            "address_purpose": "LOCATION",
            "city": "Pine City",
            "state": "MN",
            "postal_code": "55063",
            "country_code": "US",
            "telephone_number": "763-444-4838",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1706 University Ave W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043614",
            "country_code": "US",
            "telephone_number": "651-645-3661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 48th St NE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559062009",
            "country_code": "US",
            "telephone_number": "507-289-2753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1609 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551173917",
            "country_code": "US",
            "telephone_number": "651-454-2016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Gateway Dr NE",
            "address_purpose": "LOCATION",
            "city": "East Grand Forks",
            "state": "MN",
            "postal_code": "567212620",
            "country_code": "US",
            "telephone_number": "218-793-0420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11400 Julianne Ave N",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550829436",
            "country_code": "US",
            "telephone_number": "651-426-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Quail St",
            "address_purpose": "LOCATION",
            "city": "Mahtomedi",
            "state": "MN",
            "postal_code": "551151941",
            "country_code": "US",
            "telephone_number": "651-429-2311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MBH-MN MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "LILE",
        "authorized_official_first_name": "BUD",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "612-232-7558",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Anne Martyr, PHD
• Mary M. Trites, P.a.
• Marilyn Joy Fiske Mast, MS COUNSELING
• Susanna Elizabeth Matlon
• Matthew D. Berg, D.D.S., P.a. (Rice Creek Dental)
• Marzack Balasco McAllister, LADC
• Daniel McCoy, ARNP
• Anne McLellan
• Kristen McLeskey
• Medguru LLC (BetterCPAP)

• Clinic/Center in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.