Organization
FAIRMONT ORTHOPEDICS & SPORTS MEDICINE, PA
Active
Other names
Center for Specialty Care
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA LYNN THOMPSON (REVENUE CYCLE MANAGER ADMIN AP)
(507) 238-4949
Entity
Organization
Contact information
Practice address
717 S STATE ST, SUITE 900, FAIRMONT, MN 56031-4469
(507) 238-4949
(507) 238-3377
Mailing address
717 S STATE ST STE 900, FAIRMONT, MN 56031-4400
(507) 238-4949
(507) 238-3365
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
—
174400000X
Specialist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09809248
MEDICA
—
01
—
112399
UCARE
—
01
—
138808700
US DEPT OF LABOR
—
01
—
27084
SANFORD HEALTH
—
01
—
29394
HEALTHPARTNERS
—
01
—
29D51FA
BLUE CROSS BLUE SHIELD CHIROPRACTIC
MN
01
—
396G2PR
BLUE CROSS BLUE SHIELD
MN
01
—
40645WE
BLUE CROSS BLUE SHIELD
MN
05
—
590024700
—
MN
01
—
974311025203
PREF ONE
—
01
—
CB1729
RAILROAD MEDICARE
—
Enumeration date
05/20/2006
Last updated
03/26/2025
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