ST. CLOUD HOSPITAL – NPI #1912956400
Clinic/Center

ST. CLOUD HOSPITAL is an AHC clinic located in BRAINERD, MN. NPPES has assigned the NPI number 1912956400 to ST. CLOUD HOSPITAL on May 10, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. ST. CLOUD HOSPITAL is also known by the name CENTRACARE KIDNEY PROGRAM - BRAINERD DIALYSIS. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was last updated on Sep 10, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ST. CLOUD HOSPITAL below.

NPI Profile for
ST. CLOUD HOSPITAL

NPI Number
1912956400
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST. CLOUD HOSPITAL
Other Name: CENTRACARE KIDNEY PROGRAM - BRAINERD DIALYSIS
Primary location
2024 SO 6TH ST
BRAINERD, MN 56401
Phone: (218) 825-8964 Fax: (320) 656-7009
Mailing address
1406 6TH AVE NORTH
SAINT CLOUD, MN 56303-1900
Phone: (320) 251-2700 Fax: (320) 656-7009
Organization Subpart
No
Authorized Official
MICHAEL BLAIR
SR. VICE PRESIDENT AND CFO
Phone: (320) 255-5665
Updated
Identifiers

Identifiers for ST. CLOUD HOSPITAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMN883747300
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)
MN 331506

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.