ST. JOSEPH'S MEDICAL CENTER NPI 1477509776

NPI Information

  • NPI: 1477509776
  • Provider Name: ST. JOSEPH'S MEDICAL CENTER
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: ESSENTIA HEALTH ST. JOSEPH'S-CROSSLAKE CLINIC
  • CLIA Number: 24D0948617
  • Address: 35205 COUNTY ROAD 3
    CROSSLAKE, MN
    ZIP 56442
  • Phone: (218) 692-1010

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NPI Details

ST. JOSEPH'S MEDICAL CENTER is a primary care clinic center in Crosslake, MN. ST. JOSEPH'S MEDICAL CENTER NPI is 1477509776. The provider is registered as an organization entity type.
The provider Is Doing Business As Essentia Health St. Joseph's-crosslake Clinic.

The provider's business location address is:

35205 COUNTY ROAD 3
CROSSLAKE, MN
ZIP 56442-057
Phone: (218) 692-1010
Fax: (218) 692-1013

The provider's authorized official is Kevin Boren .
The authorized official title is Vp Of Finance and has the following contact phone number (218) 786-1009.

The CLIA number assigned to this NPI record is 24D0948617 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 2/27/2024.

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
1261QP2300XClinic/CenterPrimary Care330736MINNESOTAYes

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
1750027100MEDICAIDMINNESOTA

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: 3/30/2025

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