SOUTHDALE MEDICAL PARTNERS CORPORATION
NPI 1043898778
Nurse Practitioner - Primary Care in Oakdale, MN

NPI Status: Active since April 01, 2021

Contact Information

902 INWOOD AVE N STE 902
OAKDALE, MN
ZIP 55128
Phone: (952) 999-4049

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  • Organization
  • Nurse Practitioner
  • Primary Care
  • CLIA Number: 24D2265307
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-25-2026

About SOUTHDALE MEDICAL PARTNERS CORPORATION

This page provides the complete NPI Profile along with additional information for Southdale Medical Partners Corporation, a provider established in Oakdale, Minnesota operating as a Nurse Practitioner, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1043898778 assigned on April 2021. The practitioner's primary taxonomy code is 363LP2300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Southdale Medical Partners Corporation operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mitchell Paul Brandt (Administrator)

NPI
1043898778
Provider Name
SOUTHDALE MEDICAL PARTNERS CORPORATION
Entity Type
Organization
Location Address
902 INWOOD AVE N STE 902 OAKDALE, MN 55128
Location Phone
(952) 999-4049
Mailing Address
902 INWOOD AVE N SAINT PAUL, MN 55128
Mailing Phone
(651) 815-6880
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-01-2021
Last Update Date
05-03-2023
Code Navigator

A nurse practitioner (NP) like Southdale Medical Partners Corporation is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 6565 France Ave S Ste 350
    Edina, MN 55435
    (952) 999-4049

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

Nurse Practitioner Primary Care

Taxonomy Code
363LP2300X
Type
Physician Assistants & Advanced Practice Nursing Providers

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

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

MITCHELL PAUL BRANDT

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(612) 961-4322

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
24D2265307
Facility Type
Physician Office
Certificate Effective Date
July 26, 2024
Certificate Expiration Date
July 25, 2026
Laboratory Director
MERLIN E. BROWN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Southdale Medical Partners Corporation 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.

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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 1043898778, we treat the final digit (8) 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 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

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
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
9
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
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 4 → 8 8 → 16 → 7 8 → 16 → 7 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 8 + 3 + 1 + 6 + 9 + 1 + 6 + 7 + 1 + 4 + 24 = 72

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

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1043898778.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043898778, enumerated as an "organization" on April 01, 2021.

The provider is located at 902 INWOOD AVE N STE 902 OAKDALE, MN 55128 and the phone number is (952) 999-4049.

Nurse Practitioner with taxonomy code 363LP2300X and a focus in Primary Care.