NPIMap

Organization Active NPI

Shriners Hospitals for Children

  • Medical Specialty Clinic/Center
  • Woodbury, MN
National Provider Identifier
1992289490
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Practice address
215 Radio Dr Ste 100
Woodbury, MN 55125-5817
Phone
(612) 596-6100
Fax
(612) 339-7634
NPI assigned
Sep 20, 2018
Last updated
Aug 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Leslie D. Stewart
Title
President
Phone
(813) 281-0300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

215 Radio Dr Ste 100
Woodbury, MN 55125-5817

Mailing address

PO Box 8500 Lockbox 7642
Philadelphia, PA 19178-7642
Phone (813) 281-0300

Other names 1

  • Shriners Children's Twin Cities Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140606000217 MN Part B Supplier - Clinic/Group Practice 9133031933 Receives reassigned benefits from 39 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodbury, MN

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2900 N Rocky Point Dr
Tampa, FL 33607
Phone (813) 281-7135

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1992289490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500 LOCKBOX 7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-0300",
            "fax_number": "813-281-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 RADIO DR STE 100",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255817",
            "telephone_number": "612-596-6100",
            "fax_number": "612-339-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-281-0300"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shriners Children's Twin Cities",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.