ST. MARY'S MEDICAL CENTER (NPI# 1144507708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144507708 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S MEDICAL CENTER |
| Other Organization Name | BENET HALL |
| Practice Address |
1001 Kenwood Avenue Duluth MN 55811-2370 |
| Practice Telephone | 2187236564 |
| Practice Fax Number | 2187236548 |
| Mailing Telephone | 2187236564 |
| Mailing Fax Number | 2187236548 |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2013-10-04 |
| Authorized Official Name | JAMES GARVEY (EVP HOSPITAL OPERATIONS) |
| Authorized Official Telephone | 2187864878 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S DULUTH CLINIC HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 355203 | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICA - ELDERLY WAIVER | 0049-0050996 | 01 |
| Other Name | Type Code |
|---|---|
| Benet Hall | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043245921 | St. Mary's Medical Center | Home Health | 516 E 4th St, Duluth, MN 55805-1936 | 2006-07-11 |
| 1598112351 | St. Mary's Medical Center | Psychiatric Unit | 450 Stanyan St, San Francisco, CA 94117-1019 | 2016-05-20 |
| 1982088902 | St. Mary's Medical Center | General Acute Care Hospital | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 | 2015-07-20 |
| 1235278763 | St. Mary's Medical Center | Psychiatric Hospital | 450 Stanyan St, Mcauley Adolescent Day Treatment 3n, San Francisco, CA 94117-1079 | 2007-02-05 |
| 1013933936 | St. Mary's Medical Center | Clinic/Center | 407 E 3rd St, Duluth, MN 55805-1950 | 2006-07-14 |
| 1225089634 | St. Mary's Medical Center | Hospice Care, Community Based | 407 E 3rd St, Duluth, MN 55805-1950 | 2006-05-12 |
| 1558356709 | St. Mary's Medical Center | Rehabilitation Hospital | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2518 | 2005-09-14 |
| 1487656054 | St. Mary's Medical Center | General Acute Care Hospital | 201 Nw R D Mize Rd, Blue Springs, MO 64014-2518 | 2005-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | St. Mary's Medical Center PLC | 430 West Stuart Dr, Hillsville, Virginia 24343 |
| System for Award Management (SAM) Entities | ST. MARY'S MEDICAL CENTER, INC. | 2900 First Ave, Huntington, WV 25702-1241 |
| Street Address |
1001 KENWOOD AVENUE |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-2370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
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|---|---|---|---|---|
| 1225645310 | Quantum Grace Solutions LLC | Home Health | 6555 Sugarloaf Pkwy Ste 307-106, Duluth, GA 30097-4930 | 2020-09-23 |
| 1790303444 | Latravia Lishell Williams | Home Health | 1335 Herrington Rd Apt 2722, Duluth, GA 30096-6422 | 2020-07-09 |
| 1528685138 | M. A. Health Services, Inc. | Home Health | 3973 Stillwater Dr, Duluth, GA 30096-5589 | 2020-06-30 |
| 1639795610 | Dunamis Healthcare Services | Home Health | 2028 The Falls Pkwy, Duluth, GA 30096-8805 | 2020-06-25 |
| 1598233231 | Provider Partners, LLC Dba Your Virtual Clincial | Home Health | 1815 Satellite Blvd Ste 403, Duluth, GA 30097-5239 | 2018-11-12 |
| 1427532704 | 1st Option Healthcare,llc | Home Health | 1810 Peachtree Industrial Blvd Ste 215, Duluth, GA 30097-8177 | 2018-09-21 |
| 1306326475 | Caringcompanions Home Care Services LLC | Home Health | 3121 Barkley Square Dr, Duluth, GA 30097-3453 | 2018-08-18 |
| 1306359179 | Anthony Olajide | Home Health | 3780 Old Norcross Rd # 103-366, Duluth, GA 30096-1740 | 2017-11-14 |
| 1437678885 | Teleigha L Peavy | Home Health | 2695 Kingsbrooke Ln, Duluth, GA 30097-7392 | 2017-09-18 |
| 1194250233 | Katie T Dang | Home Health | 4370 Satellite Blvd, #834, Duluth, GA 30096-8843 | 2017-04-26 |
| Find all providers in DULUTH | ||||
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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.