NPIMap

Organization Active NPI

The Duluth Clinic, LTD

Doing business as Essentia Health Aurora Clinic

  • Multi-Specialty Clinic/Center
  • Aurora, MN
National Provider Identifier
1982641791
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE DULUTH CLINIC, LTD
Doing business as
Essentia Health Aurora Clinic
Practice address
405 W 3Rd Ave N
Box 392
Aurora, MN 55705-1247
Phone
(218) 229-3311
NPI assigned
Jun 1, 2006
Last updated
Feb 11, 2011By 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 Feb 11, 2011

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

Authorized official

Name
Michael Metcalf
Title
Ex. VP & Sr. Officer DC Operations
Phone
(218) 786-2625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

405 W 3Rd Ave N
Box 392
Aurora, MN 55705-1247

Mailing address

405 W 3Rd Ave N
Box 392
Aurora, MN 55705-1247
Phone (218) 229-3311

Other identifiers 1

IdentifierTypeStateIssuer
230814200MedicaidMN

Other names 1

  • Essentia Health Aurora Clinic 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 Mary's Duluth Clinic Health System

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

405 W 3rd Ave N
Aurora, MN 55705
Phone (218) 229-3311

405 W 3rd Ave N
#392
Aurora, MN 55705
Phone (218) 229-3311

730 E 34th St
Hibbing, MN 55746
Phone (218) 262-3425

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1982641791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 3RD AVE N",
            "address_2": "BOX 392",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "557051247",
            "telephone_number": "218-229-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W 3RD AVE N",
            "address_2": "BOX 392",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "557051247",
            "telephone_number": "218-229-3311"
        }
    ],
    "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": "2006-06-01",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "METCALF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EX. VP & SR. OFFICER DC OPERATIONS",
        "authorized_official_telephone_number": "218-786-2625"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230814200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Aurora Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.