Affiliated Community Medical Centers, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP3732 Issued in MN

Legal business name

AFFILIATED COMMUNITY MEDICAL CENTERS, PA

Practice address

101 Willmar Ave SW
Wilmlar, MN 56201-3591

Phone

(320) 231-5079

Fax

(320) 231-5067

NPI assigned

Apr 23, 2015

Last updated

Apr 23, 2015By 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

Ronald L Holmgren, MDNPI 1679549745

Title

President

Phone

(320) 231-5079

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Ronald L Holmgren, MD

  • Family Medicine Physician
  • Willmar, MN
  • NPI 1679549745
  Authorized official Same address or phone

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1962899302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILMLAR",
            "state": "MN",
            "postal_code": "562013591",
            "telephone_number": "320-231-5079",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILMLAR",
            "state": "MN",
            "postal_code": "562013591",
            "telephone_number": "320-231-5079",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED COMMUNITY MEDICAL CENTERS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "HOLMGREN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-231-5079",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP3732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.