ESSENTIA HEALTH VIRGINIA, LLC (NPI# 1962440362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962440362 |
| Entity Type | Organization |
| Organization Name | ESSENTIA HEALTH VIRGINIA, LLC |
| Other Organization Name | ESSENTIA HEALTH ELY CLINIC |
| Practice Address |
300 W Conan St Ely MN 55731-1145 |
| Practice Telephone | 2183657900 |
| Mailing Telephone | 2183657900 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | DANIEL NIKCEVICH (PRESIDENT) |
| Authorized Official Telephone | 2187862628 |
| Is Organization Subpart | Y |
| Parent Organization Name | SMDC HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1962440362 | 05 |
| Other Name | Type Code |
|---|---|
| Essentia Health Ely Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538107594 | Essentia Health Virginia, LLC | Clinic/Center | 71 South Dr, Babbitt, MN 55706-3702 | 2006-06-03 |
| 1386682045 | Essentia Health Virginia, LLC | Clinic/Center | 2501 Keenan Dr, International Falls, MN 56649-2181 | 2006-06-03 |
| 1083617120 | Essentia Health Virginia, LLC | General Acute Care Hospital | 901 9th St N, Virginia, MN 55792-2325 | 2005-05-23 |
| 1881144970 | Essentia Health Virginia, LLC | Clinic/Center | 2501 Keenan Dr, International Falls, MN 56649-2181 | 2016-10-12 |
| 1326598418 | Essentia Health Virginia, LLC | Clinic/Center | 300 W Conan St, Ely, MN 55731-1145 | 2016-10-12 |
| 1326595646 | Essentia Health Virginia, LLC | Clinic/Center | 71 South Dr, Babbitt, MN 55706-1232 | 2016-09-02 |
| 1396748034 | Essentia Health Virginia, LLC | Skilled Nursing Facility | 901 9th St N, Virginia, MN 55792-2348 | 2005-05-26 |
| 1114920857 | Essentia Health Virginia, LLC | Rehabilitation Unit | 901 9th St N, Virginia, MN 55792-2348 | 2005-05-26 |
| Street Address |
300 W CONAN ST |
| City | ELY |
| State | MN |
| Zip Code | 55731-1145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972131381 | Mataya Barrett | Community Health Worker | 300 W Conan St, Ely, MN 55731-1145 | 2020-03-31 |
| 1326598418 | Essentia Health Virginia, LLC | Clinic/Center | 300 W Conan St, Ely, MN 55731-1145 | 2016-10-12 |
| 1235585134 | Danyelle R Fenner | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2016-05-10 |
| 1801270798 | Nicholas Alexander Cooley | Family Medicine | 300 W Conan St, Ely, MN 55731 | 2015-07-10 |
| 1447325709 | Mary Catherine Ulmaniec Bianco | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2006-11-22 |
| 1720151004 | Jeffrey Allen Wilt | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2006-11-16 |
| 1457458531 | Joseph Michael Schwinghamer | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2006-09-20 |
| 1104837863 | Joseph Anthony Bianco | Family Medicine | 300 W Conan St, Ely, MN 55731-1145 | 2006-08-10 |
| 1164457727 | Margaret Eileen York-jesme | Nurse Practitioner | 300 W Conan St, Ely, MN 55731-1145 | 2006-07-12 |
| 1558395889 | Jeanann Tjader | Nurse Practitioner | 300 W Conan St, Ely, MN 55731-1145 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720646110 | Bria Schurke | Physician Assistant | 1101 Ring Rock Rd, Ely, MN 55731 | 2019-05-31 |
| 1851738694 | Sonya Bland | Registered Nurse | 1701 Hwy 1, Ely, MN 55731 | 2013-06-03 |
| 1063513448 | Debra K Warner | Psychologist | 224 E Chapman, Rmhc Duluth Clinic, Ely, MN 55731 | 2006-09-26 |
| 1821107541 | Lars Lyle Roth | Chiropractor | 39 E Sheridan, Ely, MN 55731 | 2006-08-29 |
| 1992943336 | Ely Family Dentistry | Dentist | 40 N 1st Ave E, Ely, MN 55731 | 2009-01-22 |
| 1417162207 | William J Scott Dds Pa | Dentist | 40 N 1st Ave E, Ely, MN 55731 | 2007-05-14 |
| 1902303670 | Scott Allen Hofstadter | Physical Therapy Assistant | 2160 Deer Ridge Rd, Ely, MN 55731-0593 | 2018-04-10 |
| 1477660777 | Boundary Waters Care Center | Skilled Nursing Facility | 200 W Conan St, Ely, MN 55731-1143 | 2006-08-23 |
| 1538503800 | Amanda Nierengarten | Occupational Therapist | 200 W Conan St, Ely, MN 55731-1143 | 2013-04-17 |
| 1710260237 | Jacob Meyer Osell | Pharmacist | 328 W. Conan St., Ely Bloomeson Community Hospital, Ely, MN 55731-1145 | 2011-09-21 |
| Find all providers in zip 55731 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
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| 1053952606 | Fairview Express Care | Clinic/Center | 2512 6th Street, Suite F105, Minneapolis, MN 55454-1401 | 2019-10-04 |
| 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 |
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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.