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ST. MARY'S REGIONAL HEALTH CENTER NPI 1275977928


NPI Information

NPI: 1275977928
Provider Name: ST. MARY'S REGIONAL HEALTH CENTER

Doing Business As: ESSENTIA HEALTH ST. MARY'S - FRAZEE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 24D2066793

Address:
300 MAIN AVE E
FRAZEE, MN
ZIP 56544
Phone: (218) 334-7255
Get Directions

ST. MARY'S REGIONAL HEALTH CENTER is a family medicine in Frazee, MN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ST. MARY'S REGIONAL HEALTH CENTER NPI is 1275977928. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Essentia Health St. Mary's - Frazee Clinic.

The provider's business location address is:

300 MAIN AVE E
FRAZEE, MN
ZIP 56544
Phone: (218) 334-7255

The provider's authorized official is Tanner Goodrich .
The authorized official title is President and has the following contact phone number (218) 847-5611.

The CLIA number assigned to this NPI record is 24D2066793 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/24/2013 and was last updated on 10/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1892442000MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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