CENTRACARE CLINIC (NPI# 1679025746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679025746 |
| Entity Type | Organization |
| Organization Name | CENTRACARE CLINIC |
| Other Organization Name | CENTRACARE HEALTH - BAXTER |
| Practice Address |
7418 Forthun Rd Baxter MN 56425-8702 |
| Mailing Address |
1200 6th Ave N Saint Cloud MN 56303-2735 |
| Practice Telephone | 3202512700 |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2018-09-14 |
| Authorized Official Name | THOMAS M FELDHEGE (DIRECTOR OF FINANCE / TREASURER) |
| Authorized Official Telephone | 3202402152 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
375987 | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CentraCare Health - Baxter | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13782 Bluestem Ct Ste 100, Baxter, MN 564258768 | 3202512700 |
| 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 |
| 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 |
7418 FORTHUN RD |
| City | BAXTER |
| State | MN |
| Zip Code | 56425-8702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396364089 | Jennifer Ann Olson | Behavioral Analyst | Autism Matters 14387 Edgewood Drive, Baxter, MN 56425 | 2020-04-13 |
| 1801229000 | Longville Lakes Clinic, Inc. | Clinic/Center | 13205 Isle Drive, Baxter, MN 56425 | 2013-08-12 |
| 1033555867 | Shiela Klemmetsen | Family Medicine | Essentia Health St. Joseph's-baxter Clinic, 13060 Isle Drive, Baxter, MN 56425 | 2013-05-20 |
| 1053547299 | Linda Marie Bowman | Social Worker | 13397 Shadow Wood Drive, Baxter, MN 56425 | 2009-06-02 |
| 1215112792 | Brainerd Medical Center, Inc. | Nurse Practitioner | 14133 Edgewood Drive, Baxter, MN 56425 | 2008-01-03 |
| 1134313208 | Sleep Center of Central Minnesota LLC | Clinic/Center | 13495 Elder Drive, Suite 120, Baxter, MN 56425 | 2007-08-31 |
| 1750582482 | Jacqueline Elizabeth Oelfke | Nurse Practitioner | Cbhh-baxter, 14241 Grand Oaks Dr., Baxter, MN 56425 | 2007-05-30 |
| 1508080631 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14398 Grand Oaks Drive, Baxter, MN 56425 | 2007-04-12 |
| 1093842247 | Five Star Living of Brainerd, LLC | Assisted Living Facility | 14396 Grand Oaks Dr, Baxter, MN 56425 | 2007-02-27 |
| 1053458364 | Teri Kaminski Peterson | Speech-Language Pathologist | 15620 Edgewood Dr Ste 240, Baxter, MN 56425 | 2007-01-30 |
| Find all providers in zip 56425 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1730731464 | St Marys Regional Health Center | Clinic/Center | 1103 1st St E, Park Rapids, MN 56470 | 2019-07-12 |
| 1003478892 | The Duluth Clinic Ltd | Clinic/Center | 4289 Ugstad Rd, Hermantown, MN 55811-3615 | 2019-07-02 |
| 1073005856 | Arbor Integrative Behavioral Health | Clinic/Center | 1000 E 1st St Ste 105, Duluth, MN 55805-2297 | 2018-06-06 |
| 1689161077 | Chs Tennessee Medical P C | Clinic/Center | 701 Brooks Ave S, Thief River Falls, MN 56701-2757 | 2018-04-20 |
| 1427557867 | Gillette Children's Specialty Healthcare | Clinic/Center | 505 Paul Bunyan Dr Nw, Bemidji, MN 56601-2400 | 2018-02-11 |
| 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.