CENTRACARE CLINIC NPI 1659425114

NPI Information

NPI: 1659425114
Provider Name: CENTRACARE CLINIC
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
:
Address: 1900 CENTRACARE CIRCLE
CENTRACARE CLINIC INTERNAL MEDICINE
ST CLOUD, MN
ZIP 56303
Phone: (320) 229-4928

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NPI Details

CENTRACARE CLINIC is a primary care clinic center in St Cloud, MN. CENTRACARE CLINIC NPI is 1659425114. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1900 CENTRACARE CIRCLE
CENTRACARE CLINIC INTERNAL MEDICINE
ST CLOUD, MN
ZIP 56303
Phone: (320) 229-4928

The provider's authorized official is Michael A Blair .
The authorized official title is Sr Vp & Cfo and has the following contact phone number (320) 255-5665.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 6/23/2025.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	261QP2300X	Clinic/Center	Primary Care			Yes

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
1	052720300	MEDICAID	MINNESOTA
2	990228700	MEDICAID	MINNESOTA

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: 11/21/2025

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