Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
PRAIRIE ST. JOHN'S CLINIC
Active
Organization
PRAIRIE ST. JOHN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY W MAGNISON CFO (CHIEF FINANCIAL OFFICER)
(701) 476-7221
Entity
Organization
Contact information
Practice address
7616 CURRELL BLVD, SUITE 100, WOODBURY, MN 55125-2290
(651) 259-9700
(651) 259-9740
Mailing address
510 4TH ST S, PO BOX 2027, FARGO, ND 58103-1914
(701) 476-7221
(701) 476-7261
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
5063A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238T5PR
MINNESOTA BLUE CROSS
MN
Enumeration date
10/11/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up