Athlos Academy of St. Cloud

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

ATHLOS ACADEMY OF ST. CLOUD

Practice address

3701 33Rd St S
Saint Cloud, MN 56301-2600

Phone

(320) 281-4430

NPI assigned

Apr 27, 2017

Organization subpart

No

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

Authorized official

Name

Kathy Mortensen

Title

Executive Director

Phone

(320) 281-4430

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1972038909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 33RD ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563012600",
            "telephone_number": "320-281-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 33RD ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563012600",
            "telephone_number": "320-281-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLOS ACADEMY OF ST. CLOUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "320-281-4430"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly Jean Benolkin Athman, GENETIC COUNSELOR
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• Rachel Atkinson
• Wendy A Atkinson, MS LP

• All providers in Saint Cloud, MN
• Local Education Agency (LEA) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.