AXIS MINNESOTA, INC.
NPI 1053475434
Intermediate Care Facility, Intellectual Disabilities in Roseville, MN

Q: What is Axis Minnesota, Inc.'s NPI number?

The NPI number for Axis Minnesota, Inc. is 1053475434. It was assigned to this organization in the NPPES registry on December 20, 2006.

Q: What is Axis Minnesota, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since December 20, 2006CLIA 24D0651217 · Waiver

692 BELMONT LN W, ROSEVILLE, MN 55113(651) 774-5940(651) 774-8126 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Axis Minnesota, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AXIS MINNESOTA, INC. (NPI 1053475434) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Roseville, Minnesota and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Denise Marie Scholljegerdes, Cfo, as its authorized official.

NPPES Registry Identity

NPI1053475434

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameAXIS MINNESOTA, INC.

Location Address692 BELMONT LN WRoseville, MN 55113-6470

Mailing Address2345 Rice St, Suite 112Roseville, MN 55113-3741 · (651) 774-5940 · Fax (651) 774-8126

Phone(651) 774-5940

Fax(651) 774-8126

Organization SubpartNo

Authorized OfficialDenise Marie ScholljegerdesCfo · (651) 774-5940

Enumeration DateDecember 20, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1053475434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

License✔ Licensed in MN · 1030626-1-RS

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

692 BELMONT LN W, Roseville, MN 55113

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D0651217

Axis Minnesota Inc · Roseville, MN

Active · expires Aug 31, 2026

CLIA Number24D0651217

Laboratory TypeIntermediate Care Facility For Mentally Retarded

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorNancy Brady

Laboratory Phone(651) 774-5940

Laboratory LocationAxis Minnesota Inc2345 Rice Street Suite 112, Roseville, MN 55113

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Axis Minnesota, Inc.'s NPI number?

The NPI number for Axis Minnesota, Inc. is 1053475434. It was assigned to this organization in the NPPES registry on December 20, 2006.

Where is Axis Minnesota, Inc. located?

Axis Minnesota, Inc. is located at 692 Belmont Ln W, Roseville, MN 55113. The listed phone number is (651) 774-5940.

What is Axis Minnesota, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Axis Minnesota, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0651217) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Axis Minnesota, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.