CENTRACARE CLINIC (NPI# 1457726549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457726549 |
| Entity Type | Organization |
| Organization Name | CENTRACARE CLINIC |
| Other Organization Name | CENTRACARE CLINIC - ALBANY |
| Practice Address |
30 Railroad Ave Albany MN 56307 |
| Mailing Address |
1200 6th Ave N Saint Cloud MN 56303-2735 |
| Practice Telephone | 3208452157 |
| Mailing Telephone | 3208452157 |
| Mailing Fax Number | 3208456138 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2019-09-16 |
| Authorized Official Name | TOM FELDHEGE (CFO CENTRACARE CLINIC) |
| Authorized Official Telephone | 3202512700 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRACARE CLINC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CentraCare Clinic - Albany | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 320 3rd Ave, Albany, MN 563079363 | 3208452157 | 3208456138 |
| 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 |
| 1164958104 | Centracare Clinic | Clinic/Center | 113 Waite Ave S Ste 101, Waite Park, MN 56387-1348 | 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 |
| 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 |
30 RAILROAD AVE |
| City | ALBANY |
| State | MN |
| Zip Code | 56307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447308770 | Jennifer Nicole Gannon | Specialist/Technologist | 30 Railroad Ave, Centracare Clinic Albany, Albany, MN 56307-9363 | 2007-01-05 |
| 1952874836 | Tess Marie King | Physician Assistant | 30 Railroad Ave, Albany, MN 56307-9379 | 2019-01-03 |
| 1649758079 | Hailey Brinkman | Physical Therapist | 30 Railroad Ave, Albany, MN 56307-9379 | 2018-07-28 |
| 1871035881 | Stephanie Ann Olson | Registered Nurse | 30 Railroad Ave, Albany, MN 56307-9379 | 2016-11-08 |
| 1720432057 | Brittany Nagel | Family Medicine | 30 Railroad Ave, Albany, MN 56307-9379 | 2016-04-22 |
| 1609241447 | St. Cloud Hospital | Clinic/Center | 30 Railroad Ave, Albany, MN 56307-9379 | 2015-12-04 |
| 1649447715 | Libby M Brever | Family Medicine | 30 Railroad Ave, Albany, MN 56307-9379 | 2008-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669023156 | Mary Jane Zeimetz | Technician | 355 Countryside Ln #6, Albany, MN 56307 | 2019-09-25 |
| 1003965047 | Harry J Larson | Dentist | 150 4th Street, Albany, MN 56307 | 2007-01-09 |
| 1952498214 | Katrina Coppicus | Occupational Therapist | 230 Church Street, Albany, MN 56307 | 2006-10-06 |
| 1104899939 | Mother of Mercy | Skilled Nursing Facility | 230 Church Avenue, Albany, MN 56307-0676 | 2006-02-10 |
| 1922302843 | Chi Health Connect At Home - Fargo | Hospice Care, Community Based | 131 8th Street South, Suite 1, Albany, MN 56307-0776 | 2011-01-06 |
| 1093019754 | Chi Health Connect At Home - Fargo | Home Health | 131 8th Street South, Suite 1, Albany, MN 56307-0776 | 2011-01-10 |
| 1427108273 | Robert C. Schwegler, Dds Pa | Clinic/Center | 421 Railroad Ave, Albany, MN 56307-0808 | 2007-01-12 |
| 1700408796 | Jessica Michael Lindquist | Counselor | 1185 Cranberry St, Albany, MN 56307-4518 | 2020-05-12 |
| 1417440223 | Megan Raiber | Dentist | 360 Railroad Ave, Albany, MN 56307-6201 | 2018-06-07 |
| 1730526419 | Leslie Marie Young | Counselor | 161 4th St Ste B, Albany, MN 56307-8356 | 2013-06-04 |
| Find all providers in zip 56307 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1215042221 | Albany Nuclear Medicine PC | Clinic/Center | 1365 Washington Ave, Albany, NY 12206-1098 | 2006-08-20 |
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| 1992224331 | Orthopedic & Sports Physical Therapy, Inc. | Clinic/Center | 322 N Tower Rd, Fergus Falls, MN 56537-1015 | 2017-09-18 |
| 1003339789 | Centracare Clinic | Clinic/Center | 2025 Stearns Way Ste 114, Saint Cloud, MN 56303 | 2017-07-25 |
| Find all providers with the same taxonomy | ||||
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| 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.