ESSENTIA HEALTH WELLNESS CLINIC HERMANTOWN
NPI 1003478892
Clinic/Center - Multi-Specialty in Hermantown, MN

NPI Status: Active since July 02, 2019

Contact Information

4289 UGSTAD RD
HERMANTOWN, MN
ZIP 55811
Phone: (218) 786-3100
Fax: (218) 576-0779

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  • Organization
  • Clinic/Center
  • Multi-Specialty
  • Accepts Insurance
  • CLIA Number: 24D0669702
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-30-2027

About ESSENTIA HEALTH WELLNESS CLINIC HERMANTOWN

This page provides the complete NPI Profile along with additional information for Essentia Health Wellness Clinic Hermantown, a provider established in Hermantown, Minnesota operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1003478892 assigned on July 2019. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Essentia Health Wellness Clinic Hermantown. The authorized official of this NPI record is Kevin Boren (Vp Finance)

NPI
1003478892
Provider Legal Name
THE DULUTH CLINIC LTD
Other Organization Name
ESSENTIA HEALTH WELLNESS CLINIC HERMANTOWN
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4289 UGSTAD RD HERMANTOWN, MN 55811
Location Phone
(218) 786-3100
Location Fax
(218) 576-0779
Mailing Address
4289 UGSTAD RD HERMANTOWN, MN 55811
Mailing Phone
(218) 786-3100
Mailing Fax
(218) 576-0779
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
07-02-2019
Last Update Date
02-28-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Multi-Specialty

Taxonomy Code
261QM1300X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Atlas $1,300 Gold - PPO
  • Atlas $2,000 Standard Gold - PPO
  • Atlas $3,050 Plus Silver - PPO
  • Atlas $3,800 HSA Silver - PPO
  • Atlas $6,000 Standard Silver - PPO
  • Atlas $6,800 Plus Bronze HSA - PPO
  • Atlas $7,500 Standard Bronze HSA - PPO
  • Atlas $8,400 HSA Bronze - PPO
  • Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Bronze Share - HMO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - HMO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Share - HMO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Gold Standard - HMO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Share - HMO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Essentia Choice Care with Medica Silver Standard - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze Share - HMO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $10,600 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,500 - PPO
  • Sanford Individual Simplicity $7,200 HSA Qualified - PPO
  • Sanford Individual Simplicity Standardized $2,000 - PPO
  • Sanford Individual Simplicity Standardized $6,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • Premier $2,000 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,000 - 50% - HMO
  • Premier $5,000 HDHP - HMO
  • Premier $6,000 - 40% - HMO
  • Premier $7,500 - HMO
  • Premier $7,500 HDHP - HMO
  • Select $2,000 - 25% - EPO
  • Select $3,500 - 30% - EPO
  • Select $4,000 - 50% - EPO
  • Select $5,000 HDHP - EPO
  • Select $6,000 - 40% - EPO
  • Select $7,500 - EPO
  • Select $7,500 HDHP - EPO
  • Select $9,500 - EPO
  • Select Protection - EPO
  • Premier HMO $1,500 - 30% - HMO
  • Premier HMO $2,500 - 20% Copay - HMO
  • Premier HMO $3,400 - 30% HDHP - HMO
  • Premier HMO $3,500 - 30% - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KEVIN BOREN

Authorized Official Title
VP FINANCE
Authorized Official Phone
(218) 786-1009

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D0669702
Facility Type
Physician Office
Certificate Effective Date
October 01, 2025
Certificate Expiration Date
September 30, 2027
Laboratory Director
SANDRA MATTSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Essentia Health Wellness Clinic Hermantown to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for ESSENTIA HEALTH WELLNESS CLINIC HERMANTOWN

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003478892, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
8
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 4 → 8 8 → 16 → 7 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 8 + 7 + 1 + 6 + 8 + 1 + 8 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1003478892.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Physical Therapist
4289 UGSTAD RD
HERMANTOWN, MN 55811
Physical Therapist
4289 UGSTAD RD
HERMANTOWN, MN 55811
Health Educator
4289 UGSTAD RD
HERMANTOWN, MN 55811
Health Educator
4289 UGSTAD RD
HERMANTOWN, MN 55811
Social Worker (Clinical)
4289 UGSTAD RD
HERMANTOWN, MN 55811
Physical Therapist
4289 UGSTAD RD
HERMANTOWN, MN 55811

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003478892, enumerated as an "organization" on July 02, 2019.

The provider is located at 4289 UGSTAD RD HERMANTOWN, MN 55811 and the phone number is (218) 786-3100.

Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.

The provider might be accepting Accepts: HealthPartners, Medica, Sanford Health Plan and. Please consult your insurance carrier or call the provider to verify.