| NPI | 1164978219 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2016-08-29 |
| Last Updated | 2025-06-23 |
| Authorized Official | Michael Blair SR VP & CFO Phone: 3202555665 |
| Mailing Address | 1200 6th Ave N Saint Cloud, MN 56303-2735 United States Phone: (320) 252-5131 | Fax: (320) 240-2118 📍 View Map |
| Primary Practice Address | 3701 12th St N, Suite 100 Saint Cloud, MN 56303-2255 United States Phone: (320) 253-7257 | Fax: (320) 251-2938 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | MN | 110890 | UCare |
| Other (non-Medicare) | MN | 35580 | Health Partners |
| Other (non-Medicare) | MN | 6D053CE | Blue Cross Blue Shield |
| Other (non-Medicare) | MN | 98-04122 | Medica |
| Other (non-Medicare) | MN | 990228700 | Medicaid |
| Other (non-Medicare) | MN | N002912 | Champus |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 261Q00000X – Clinic/Center | MN | - |
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About NPI 1164978219
Centracare Clinic is an organization registered in the CMS NPPES NPI Registry with NPI number 1164978219. The primary specialty listed is Clinic/Center. The organization is located in Saint Cloud, MN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2016-08-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1164978219?
NPI 1164978219 belongs to Centracare Clinic, a Clinic/Center in Saint Cloud, MN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1164978219 active?
The current status of NPI 1164978219 in the NPPES registry is Active. The record was last updated on 2025-06-23.
What specialty is NPI 1164978219?
NPI 1164978219 is classified under the taxonomy Clinic/Center. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1164978219?
You can verify NPI 1164978219 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1164978219?
The primary practice address on file for NPI 1164978219 is 3701 12th St N, Saint Cloud, MN 56303-2255. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1164978219 issued?
NPI 1164978219 was first issued (enumerated) on 2016-08-29. The NPPES record was last updated on 2025-06-23.
Practice Location Map
Centracare Clinic is located at 3701 12th St N, Saint Cloud, MN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Centracare Clinic. All records sourced from the CMS NPPES registry.