CENTRACARE CLINIC (NPI# 1164958104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164958104 |
| Entity Type | Organization |
| Organization Name | CENTRACARE CLINIC |
| Other Organization Name | CENTRACARE QUICKCLINIC - WAITE PARK |
| Practice Address |
113 Waite Ave S Ste 101 Waite Park MN 56387-1348 |
| Mailing Address |
1200 6th Ave N Saint Cloud MN 56303-2735 |
| Practice Telephone | 3206567127 |
| Mailing Telephone | 3202525131 |
| Mailing Fax Number | 3202402118 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | THOMAS M FELDHEGE (TREAS/DIR OF FINANCE) |
| Authorized Official Telephone | 3202402152 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CentraCare quickClinic - Waite Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| 1720500309 | Centracare Clinic | Clinic/Center | 2749 Sexton Drive, Mary Hall - Room 001, Collegeville, MN 56321 | 2017-07-14 |
| 1881116747 | Centracare Clinic | Clinic/Center | 402 Red River Ave N Ste 2, Cold Spring, MN 56320-1523 | 2017-07-12 |
| 1558898387 | Centracare Clinic | Clinic/Center | 161 Glen St., Ste 101, Foley, MN 56329 | 2017-05-11 |
| 1770020489 | Centracare Clinic | Clinic/Center | 2001 Stockinger Drive, Suite 101, St Cloud, MN 56303 | 2017-01-20 |
| 1679025746 | Centracare Clinic | Clinic/Center | 7418 Forthun Rd, Baxter, MN 56425-8702 | 2016-10-25 |
| 1962958611 | Centracare Clinic | Exclusive Provider Organization | 166 19th Street S, Suite 202, Sartell, MN 56377 | 2016-08-31 |
| 1700281953 | Centracare Clinic | Urology | 2351 Connecticut Ave S, Suite 200, Centracare Clinic- Adult & Pediatric Urology, Sartell, MN 56377-2477 | 2014-10-30 |
| 1043212665 | Centracare Clinic | Clinic/Center | 1200 Sixth Ave No, Centracare Clinic, St Cloud, MN 56303-2735 | 2005-08-12 |
| 1881696490 | Centracare Clinic | Durable Medical Equipment & Medical Supplies | 1555 Northway Drive, St Cloud, MN 56303 | 2005-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTRACARE CLINIC RIVER CAMPUS | 1200 6th Ave N, Saint Cloud, MN 56303-2735 |
| Street Address |
113 WAITE AVE S STE 101 |
| City | WAITE PARK |
| State | MN |
| Zip Code | 56387-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962041269 | Kayli Marie Brzinski | Massage Therapist | 700 Division St, Waite Park, MN 56387 | 2020-01-03 |
| 1457836454 | Group Health Plan, Inc | Clinic/Center | 430 Great Oak Drive, Waite Park, MN 56387 | 2018-09-26 |
| 1467826016 | Nogob Transportion Inc | Non-emergency Medical Transport (VAN) | 427 Sundial Drive, Waite Park, MN 56387 | 2015-11-19 |
| 1790043271 | Ruth Marie Kuhlman | Psychologist | 110 2nd Street South, Suite 203, Waite Park, MN 56387 | 2012-05-02 |
| 1538463435 | Bjerke Counseling Services, LLC | Community/Behavioral Health | 110 Second Street, South, Suite 303, Waite Park, MN 56387 | 2011-01-06 |
| 1578799714 | Councseling Associates, Pa | Marriage & Family Therapist | 110 Second Street South, Suite 304, Waite Park, MN 56387 | 2009-06-02 |
| 1063678357 | Chiropractic Connection Pllc | Chiropractor | 2103 Frontage Rd N, #19, Waite Park, MN 56387 | 2008-08-06 |
| 1891972584 | Jill M Braaten | Chiropractor | 750 1st Street South, Suite 103, Waite Park, MN 56387 | 2008-01-25 |
| 1609053396 | Braaten Chiropractic LLC | Chiropractor | 750 1st. St. S. Ste 103, Waite Park, MN 56387 | 2008-01-25 |
| 1093849622 | Thomas Edward Monsen | Social Worker | 504 Industrial Boulevard, Waconia, MN 56387 | 2007-03-15 |
| Find all providers in zip 56387 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710251384 | Ellingson Chiropractic Clinic, PC | Clinic/Center | 140 3rd St N, Waite Park, MN 56387-1206 | 2012-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423252 | Good Clinic Mn Pllc | Clinic/Center | 315 1st Ave Ne, Minneapolis, MN 55413-5001 | 2020-09-30 |
| 1407496219 | Hope Health Initiative | Clinic/Center | 6818 Humboldt Ave N, Brooklyn Center, MN 55430-1536 | 2020-01-09 |
| 1902392525 | Odam Medical Group | Clinic/Center | 3405 3rd St N, Saint Cloud, MN 56303-4015 | 2018-07-06 |
| 1376041822 | Piic Clinical Services | Clinic/Center | 6500 Humboldt Ave N, Brooklyn Center, MN 55430-1800 | 2018-01-30 |
| 1760905475 | Patient Centered Care | Clinic/Center | 8240 Hampshire Ct N, Brooklyn Park, MN 55445 | 2017-07-25 |
| 1740703339 | Neopath | Clinic/Center | 119 30th Ave W Ste 119, Alexandria, MN 56308-3433 | 2017-07-25 |
| 1720500309 | Centracare Clinic | Clinic/Center | 2749 Sexton Drive, Mary Hall - Room 001, Collegeville, MN 56321 | 2017-07-14 |
| 1881116747 | Centracare Clinic | Clinic/Center | 402 Red River Ave N Ste 2, Cold Spring, MN 56320-1523 | 2017-07-12 |
| 1558898387 | Centracare Clinic | Clinic/Center | 161 Glen St., Ste 101, Foley, MN 56329 | 2017-05-11 |
| 1306388269 | Quadmed Medical Clinics of Minnesota, P.C. | Clinic/Center | 9000 Plymouth Ave N, Golden Valley, MN 55427-3870 | 2016-11-09 |
| Find all providers with the same taxonomy | ||||
| City | WAITE PARK |
| Zip Code | 56387 |
Please comment or provide details below to improve the information on CENTRACARE CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.