ST. CLOUD HOSPITAL (NPI# 1770532426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770532426 |
| Entity Type | Organization |
| Organization Name | ST. CLOUD HOSPITAL |
| Other Organization Name | CENTRA CARE FAMILY HEALTH CENTER |
| Practice Address |
1555 Northway Drive Suite 200 St Cloud MN 56303-4913 |
| Practice Telephone | 3202403157 |
| Practice Fax Number | 3202403143 |
| Mailing Telephone | 3202403157 |
| Mailing Fax Number | 3202403143 |
| Enumeration Date | 2006-05-09 |
| 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 | Y |
| Parent Organization Name | ST CLOUD HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | 331506 | MN | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 616053100 | 05 | |
| MN | CENTRACARE LAB | 690000070 | 01 |
| MN | 690009424 | RR MEDICARE | 01 |
| Other Name | Type Code |
|---|---|
| Centra Care Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841616877 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1495 10th Ave Ne, Sauk Rapids, MN 56379 | 2014-03-14 |
| 1912338666 | St. Cloud Hospital | Rehabilitation, Substance Use Disorder Unit | 1428 2nd St N, Sauk Rapids, MN 56379-2533 | 2013-12-06 |
| 1780020925 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1572 Co Rd 134, St. Cloud, MN 56303-0346 | 2013-05-15 |
| 1811150618 | St. Cloud Hospital | Rehabilitation, Substance Use Disorder Unit | 1564 Cty Rd 134, St Cloud, MN 56303-0346 | 2008-07-02 |
| 1427218957 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1485 10th Ave Ne, Sauk Rapids, MN 56379-9838 | 2008-06-09 |
| 1033391099 | St. Cloud Hospital | Clinic/Center | 520 Hwy 12 East, Suite 6, Litchfield, MN 55355 | 2007-12-03 |
| 1316063233 | St. Cloud Hospital | Clinic/Center | 520 11th Ave Sw, South Building, Cambridge, MN 55008-2003 | 2007-03-22 |
| 1912956400 | St. Cloud Hospital | Clinic/Center | 2024 So 6th St, Brainerd, MN 56401 | 2006-05-10 |
| 1821047317 | St. Cloud Hospital | Clinic/Center | 2035 15th St N, Suite 220, Saint Cloud, MN 56303-1738 | 2006-05-10 |
| 1760431266 | St. Cloud Hospital | Clinic/Center | 111 17th Ave East, Alexandria, MN 56308 | 2006-05-10 |
| Street Address |
1555 NORTHWAY DRIVE SUITE 200 |
| City | ST CLOUD |
| State | MN |
| Zip Code | 56303-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881696490 | Centracare Clinic | Durable Medical Equipment & Medical Supplies | 1555 Northway Drive, St Cloud, MN 56303 | 2005-08-12 |
| 1891077475 | Nicole Ann Ouke | Nurse Practitioner | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2011-09-09 |
| 1487847752 | Endodontic Professionals Pa St Cloud Endodontics | Dentist | 1555 Northway Drive, Suite 210, St Cloud, MN 56303 | 2007-08-21 |
| 1366580136 | Jimmie Lewis Browning | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2007-02-02 |
| 1508885013 | Dennis L Peterson | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-07-18 |
| 1285660548 | Kevin R Switzer | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-06-25 |
| 1326097882 | Paul M Wenner | Psychologist | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-05-10 |
| 1316915325 | Joseph M Blonski | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-08 |
| 1851369862 | Thomas John Satre | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-08 |
| 1013984491 | Penny L Rubesh | Nurse Practitioner | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-03 |
| Find all providers in the same location | ||||
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1053877506 | Premier Med Pa | Clinic/Center | 2906 17th St., St Cloud, FL 34769 | 2019-02-20 |
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| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 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.