MBH-MN MEDICAL CLINIC PA (NPI# 1922586270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922586270 |
| Entity Type | Organization |
| Organization Name | MBH-MN MEDICAL CLINIC PA |
| Practice Address |
550 Main St Ste 260 New Brighton MN 55112-3273 |
| Mailing Address |
550 Main St # 190 New Brighton MN 55112-3271 |
| Practice Telephone | 6123267558 |
| Mailing Telephone | 6124542046 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-08-30 |
| Authorized Official Name | BUD LILE (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6122327558 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 104 S 4th St, Olivia, MN 562771589 | 3204000001 | |
| 109 N Shore Dr, Waverly, MN 553905517 | 7636585800 | |
| 1111 Gateway Dr Ne, East Grand Forks, MN 567212620 | 2187930420 | |
| 114 N Holcombe Ave, Litchfield, MN 553552210 | 3206932461 | |
| 11400 Julianne Ave N, Stillwater, MN 550829436 | 6514263300 | |
| 11900 Wayzata Blvd Ste 100, Minnetonka, MN 553052018 | 6124542102 | |
| 135 Colorado St E, Saint Paul, MN 551072244 | 6514897740 | |
| 140 Quail St, Mahtomedi, MN 551151941 | 6514292311 | |
| 1609 Jackson St, Saint Paul, MN 551173917 | 6514542016 | |
| 1680 Airport Rd N, Worthington, MN 561873500 | 5073763916 | |
| 1706 University Ave W, Saint Paul, MN 551043614 | 6516453661 | |
| 17305 Meadow Creek Lane, Pine City, MN 55063 | 7634444838 | |
| 1821 University Ave W Ste 385, Saint Paul, MN 551042872 | 6516470095 | |
| 1825 Curve Crest Blvd W Ste 103, Stillwater, MN 550826054 | 6513519325 | |
| 19230 Evans St Nw Ste 203, Elk River, MN 553301574 | 6122481455 | |
| 2215 S 6th St, Brainerd, MN 564015549 | 2184541010 | |
| 2480 S County Road 45, Owatonna, MN 550605113 | 6124542130 | |
| 2807 Brookdale Dr, Brooklyn Park, MN 554441844 | 7632379898 | |
| 320 Sunrise Dr Ste B, Saint Peter, MN 560821353 | 5079310918 | |
| 3329 University Ave Se, Minneapolis, MN 554143325 | 6124542340 | |
| 3470 Washington Dr Ste 165, Eagan, MN 551223517 | 6514542833 | |
| 4800 48th St Ne, Rochester, MN 559062009 | 5072892753 | |
| 6043 Hudson Rd Ste 220, Woodbury, MN 551251033 | 6519258200 | |
| 7300 Estes Ave Sw, Waverly, MN 553908432 | 7636585800 |
| Street Address |
550 MAIN ST STE 260 |
| City | NEW BRIGHTON |
| State | MN |
| Zip Code | 55112-3273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729704 | Owegio Wreh | Technician | 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 | 2020-04-22 |
| 1205497435 | Silver Lake Smiles Family Dentistry | Clinic/Center | 2370 Palmer Drive, New Brighton, MN 55112 | 2019-06-27 |
| 1932766169 | Matthew Thomas Hanowski | Dentist | 2442 Mounds View Boulevard, Mounds View, MN 55112 | 2019-05-22 |
| 1437619988 | Marjean Diane Leary | Registered Nurse | 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 | 2019-03-21 |
| 1558802728 | Krishna Katira | Student in an Organized Health Care Education/Training Program | 2442 County Hwy 10, Mounds View, MN 55112 | 2017-03-20 |
| 1245781608 | Evan Fredrick Lieberman | Counselor | 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 | 2016-10-20 |
| 1093262065 | Ryan Zinken | Nurse Practitioner | 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 | 2016-09-07 |
| 1447703228 | Alison Glodek | Social Worker | 2543 17th St Nw, New Brighton, MN 55112 | 2016-07-28 |
| 1659728194 | Ge Vang Sr. | Driver | 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 | 2016-05-14 |
| 1114373578 | Jessica Gapinski | Specialist/Technologist | 3900 Bethel Drive, Arden Hills, MN 55112 | 2016-05-04 |
| Find all providers in zip 55112 | ||||
| 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). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881253037 | Healthemed, Inc. | Clinic/Center | 1820 Old Highway 8 Nw Ste 300, New Brighton, MN 55112-1829 | 2019-06-11 |
| 1851766059 | Fairview Health Services | Clinic/Center | 1151 Silver Lake Rd Nw, New Brighton, MN 55112-6324 | 2015-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
| City | NEW BRIGHTON |
| Zip Code | 55112 |
Please comment or provide details below to improve the information on MBH-MN MEDICAL CLINIC PA.
| 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.