CENTRACARE CLINIC – NPI #1366192759
Clinic/Center

CENTRACARE CLINIC is an AHC clinic located in SAINT CLOUD, MN. NPPES has assigned the NPI number 1366192759 to CENTRACARE CLINIC on March 28, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QX0100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Occupational Medicine

The NPI profile was last updated on Jun 23, 2025. 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 CENTRACARE CLINIC below.

NPI Profile for
CENTRACARE CLINIC

NPI Number
1366192759
Enumeration Date

(more than 4 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
CENTRACARE CLINIC
Primary location
1301 33RD ST S
SAINT CLOUD, MN 56301-9668
Phone: (320) 251-9675 Fax: (320) 240-2189
1 Other location(s):
101 Willmar Ave SW
Willmar, MN 56201-3556
Phone: (320) 231-5054
Fax: (320) 231-6300
Mailing address
1200 6TH AVE N
SAINT CLOUD, MN 56303-2736
Phone: (320) 252-5131 Fax:
Organization Subpart
Yes - CENTRACARE CLINIC is subpart of another organization.
Authorized Official
MICHAEL BLAIR
CFO
Phone: (320) 255-5665
Updated
Certification Date
Jun 23, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
261QX0100X
- Clinic/Center / Occupational Medicine (Primary)

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.