ST CLOUD HOSPITAL (NPI# 1629027123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629027123 |
| Entity Type | Organization |
| Organization Name | ST CLOUD HOSPITAL |
| Other Organization Name | CENTRACARE KIDNEY PROGRAM |
| Practice Address |
1406 6th Ave North Saint Cloud MN 56303-1900 |
| Practice Telephone | 3202512700 |
| Practice Fax Number | 3206567009 |
| Mailing Telephone | 3202512700 |
| Mailing Fax Number | 3206567009 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-07-17 |
| Authorized Official Name | MR. GREGORY R KLUGHERZ (VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 3202555665 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
331506 | MN | Ambulatory Health Care Facilities |
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 883747300 | 05 |
| Other Name | Type Code |
|---|---|
| CentraCare Kidney Program | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639332463 | St Cloud Hospital | Substance Abuse Rehabilitation Facility | 1420 2nd St N, Sauk Rapids, MN 56379-2533 | 2008-07-02 |
| 1861651549 | St Cloud Hospital | Substance Abuse Rehabilitation Facility | 121 Park Ave S, Saint Cloud, MN 56301-3780 | 2008-06-06 |
| 1124674478 | St Cloud Hospital | Clinic/Center | 200 Bunker Hill Dr, Aitkin, MN 56431-1865 | 2019-08-13 |
| 1043757404 | St Cloud Hospital | Clinic/Center | 30 25th Ave S, Saint Cloud, MN 56301-6285 | 2017-01-24 |
| Street Address |
1406 6TH AVE NORTH |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619934627 | St. Cloud Hospital | Psychiatric Unit | 1406 6th Ave North, Saint Cloud, MN 56303-1900 | 2006-04-26 |
| 1891294211 | Beverly Ione Archer | Counselor | 1406 6th Ave North, Saint Cloud, MN 56303-1901 | 2018-02-12 |
| 1326097833 | Centracare Health Systems | Clinical Medical Laboratory | 1406 6th Ave North, Saint Cloud, MN 56303-1900 | 2006-05-10 |
| 1043269798 | St. Cloud Hospital | General Acute Care Hospital | 1406 6th Ave North, Saint Cloud, MN 56303-1900 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871995415 | Meesa Dialysis LLC | Clinic/Center | 30 25th Ave S, Saint Cloud, MN 56301-6285 | 2014-09-25 |
| 1245410091 | South Central Florida Dialysis Partners LLC | Clinic/Center | 4750 Old Canoe Creek Rd, Saint Cloud, FL 34769-1430 | 2007-11-09 |
| 1699709824 | Dialysis Partners 1 Inc. | Clinic/Center | 220 Kissimmee Park Rd, Saint Cloud, FL 34769-1547 | 2006-07-11 |
| 1821047317 | St. Cloud Hospital | Clinic/Center | 2035 15th St N, Suite 220, Saint Cloud, MN 56303-1738 | 2006-05-10 |
| 1043757404 | St Cloud Hospital | Clinic/Center | 30 25th Ave S, Saint Cloud, MN 56301-6285 | 2017-01-24 |
| 1063880854 | Sunapee Dialysis LLC | Clinic/Center | 4750 Old Canoe Creek Rd, Saint Cloud, FL 34769-1430 | 2015-09-10 |
| 1083885990 | St. Cloud Hospital | Clinic/Center | 2035 15th St N, Suite 210, Saint Cloud, MN 56303-1738 | 2008-03-19 |
| 1891966701 | St. Cloud Hospital | Clinic/Center | 2035 15th St N, Suite 210, Saint Cloud, MN 56303-1738 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183832 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 6160 Summit Dr N Ste 150, Brooklyn Center, MN 55430-2118 | 2020-10-28 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1225541055 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 7433 Currell Blvd, Woodbury, MN 55125-2217 | 2017-11-15 |
| 1154856839 | Avera Marshall | Clinic/Center | 300 S Bruce St Ste D, Marshall, MN 56258-1934 | 2017-05-01 |
| 1225573777 | Atlantic Dialysis LLC | Clinic/Center | 1802 Commerce Dr, North Mankato, MN 56003-1800 | 2016-12-19 |
| 1437694981 | Atlantic Dialysis LLC | Clinic/Center | 701 N Broadway St, New Ulm, MN 56073-1201 | 2016-12-19 |
| 1467801860 | Total Renal Care, Inc. | Clinic/Center | 20184 Heritage Dr, Lakeville, MN 55044-6855 | 2016-06-07 |
| 1003292392 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 17592 Dodd Blvd, Lakeville, MN 55044-3909 | 2015-08-10 |
| 1629461470 | Babler Dialysis, LLC | Clinic/Center | 2660 S Broadway, Ste A, Rochester, MN 55904-6263 | 2015-03-17 |
| 1588067391 | Meesa Dialysis LLC | Clinic/Center | 245 Isle St W, Isle, MN 56342-4908 | 2014-10-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on ST CLOUD HOSPITAL.
| 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.