CENTRACARE HEALTH-PAYNESVILLE LLC (NPI# 1629402516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629402516 |
| Entity Type | Organization |
| Organization Name | CENTRACARE HEALTH-PAYNESVILLE LLC |
| Other Organization Name | CENTRACARE HEALTH - PAYNESVILLE CLINIC |
| Practice Address |
200 W 1st St Paynesville MN 56362-1445 |
| Practice Telephone | 3202433767 |
| Practice Fax Number | 3202433174 |
| Mailing Telephone | 3202433767 |
| Mailing Fax Number | 3202433174 |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 3202555665 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CentraCare Health - Paynesville Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457788994 | Centracare Health-paynesville LLC | Assisted Living Facility | 311 Washburne Ave, Paynesville, MN 56362-1658 | 2013-09-30 |
| 1457786972 | Centracare Health-paynesville LLC | Medicare Defined Swing Bed Unit | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-09-04 |
| 1033543921 | Centracare Health-paynesville LLC | Skilled Nursing Facility | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-08-27 |
| 1700219383 | Centracare Health-paynesville LLC | Clinic/Center | 405 Meeker Ave E, Eden Valley, MN 55329-1629 | 2013-08-19 |
| 1144653734 | Centracare Health-paynesville LLC | Clinic/Center | 130 1st St Ne, Richmond, MN 56368-8183 | 2013-08-19 |
| 1386077022 | Centracare Health-paynesville LLC | Clinic/Center | 505 Nelson Ave, Belgrade, MN 56312-2601 | 2013-08-16 |
| 1205269941 | Centracare Health-paynesville LLC | General Acute Care Hospital | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-08-16 |
| 1912330663 | Centracare Health-paynesville LLC | Clinic/Center | 308 5th Ave S, Suite 100, Cold Spring, MN 56320-2341 | 2013-08-16 |
| Street Address |
200 W 1ST ST |
| City | PAYNESVILLE |
| State | MN |
| Zip Code | 56362-1445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942291539 | Kristine M Cervin | Pharmacist | 200 W 1st St, Paynesville, MN 56362-1445 | 2005-11-02 |
| 1356942478 | Atuobi Nana Yiadom | Pharmacist | 200 W 1st St, Paynesville, MN 56362-1445 | 2020-11-04 |
| 1427568500 | Sarah Jane Revermann | Nurse Practitioner | 200 W 1st St, Paynesville, MN 56362-1445 | 2017-10-03 |
| 1225550858 | Thakul None Rattanasuwan | Pharmacist | 200 W 1st St, Paynesville, MN 56362-1445 | 2017-07-14 |
| 1982152161 | Erin Warner | Pharmacist | 200 W 1st St, Paynesville, MN 56362-1445 | 2016-09-15 |
| 1356795108 | John Kenneth Tronnes | Family Medicine | 200 W 1st St, Paynesville, MN 56362-1445 | 2016-04-18 |
| 1194100164 | Wendy Michelle Miller | Registered Nurse | 200 W 1st St, Paynesville, MN 56362-1445 | 2015-07-20 |
| 1447679188 | Christopher Anderson | Family Medicine | 200 W 1st St, Paynesville, MN 56362-1445 | 2014-04-09 |
| 1457786972 | Centracare Health-paynesville LLC | Medicare Defined Swing Bed Unit | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-09-04 |
| 1033543921 | Centracare Health-paynesville LLC | Skilled Nursing Facility | 200 W 1st St, Paynesville, MN 56362-1445 | 2013-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174055321 | Ginelle Rae Zimmerman | Family Medicine | 200 W 1st Street, Paynesville, MN 56362 | 2017-03-28 |
| 1710173877 | Jennifer Ann Klocker | Pharmacist | 200 West First Street, Paynesville, MN 56362 | 2007-09-21 |
| 1033322599 | Teresa Marie Winter | Massage Therapist | 750 State Hwy 55, Paynesville, MN 56362 | 2007-05-08 |
| 1336225838 | Donald Arther Millner | Dentist | 204 West James Street, Paynesville, MN 56362 | 2006-10-27 |
| 1760485908 | Todd D Lemke | Pharmacist | 200 First St W, Paynesville, MN 56362 | 2005-05-23 |
| 1275846487 | Paynesville Area Living At Home Block Nurse Program | Voluntary or Charitable | 1105 W Main St, Paynesville, MN 56362-1000 | 2010-07-16 |
| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| 1932404688 | Serenity Path Inc. | Clinic/Center | 117 W James St, Box 3, Paynesville, MN 56362-1216 | 2011-01-11 |
| 1730709007 | Lisa Joy Klein-conrad | Counselor | 117 W James St, Paynesville, MN 56362-1216 | 2020-04-16 |
| 1083256002 | Lauren A Foster | Peer Specialist | 117 W James St, Paynesville, MN 56362-1216 | 2019-10-10 |
| Find all providers in zip 56362 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821295239 | Raymond Jacob Lindeman | Clinic/Center | 16042 Lake Koronis Rd, Paynesville, MN 56362-9450 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902364482 | St Mary's Regional Health Center | Clinic/Center | 300 E Main Ave, Frazee, MN 56544-4504 | 2019-03-04 |
| 1508378324 | International Falls Memorial Hospital Association | Clinic/Center | 912 Main St Unit C, Littlefork, MN 56653-9379 | 2017-11-02 |
| 1407262405 | Tri-county Hospital, Inc. | Clinic/Center | 102 Farwell St S, Verndale, MN 56481 | 2014-07-10 |
| 1457624272 | Sanford Health of Northern Minnesota | Clinic/Center | 22 Elm St Nw, Clearbrook, MN 56634 | 2012-02-10 |
| 1750671186 | Riverview Healthcare Association | Clinic/Center | 306 N Mill St, Fertile, MN 56540-4330 | 2011-04-19 |
| 1952690034 | Hendricks Community Hospital Assn & Retirement Home | Clinic/Center | 315 N Norman St, Ivanhoe, MN 56142-9580 | 2011-03-29 |
| 1992012207 | County of Kanabec | Clinic/Center | 1425 Main Street North, Pine City, MN 55063-1530 | 2010-09-08 |
| 1578736492 | Healthpartners Rc | Clinic/Center | 131 Birch Avenue, Hector, MN 55342-0117 | 2008-04-11 |
| 1730352675 | Healthpartners Rc | Clinic/Center | 420 Main Street North, Renville, MN 56284-0606 | 2008-04-11 |
| 1578735833 | County of Murray | Clinic/Center | 119 N St Paul Ave, Fulda, MN 56131-1156 | 2008-03-27 |
| Find all providers with the same taxonomy | ||||
| City | PAYNESVILLE |
| Zip Code | 56362 |
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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.