ESSENTIA HEALTH ST. JOSEPH'S - HACKENSACK CLINIC
NPI 1083910699
Non-Pharmacy Dispensing Site in Hackensack, MN

Active since January 28, 2011CLIA 24D1088668 · Waiver
110 3RD ST. S, HACKENSACK, MN 56452(218) 675-5044 Get Directions Write a Review

NPPES record last updated: January 28, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Essentia Health St. Joseph's - Hackensack Clinic NPPES

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

ESSENTIA HEALTH ST. JOSEPH'S - HACKENSACK CLINIC (NPI 1083910699) is a healthcare organization registered as a non-pharmacy dispensing site in Hackensack, Minnesota and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Jani Wiebolt, President, as its authorized official.

NPPES Registry Identity

NPI1083910699
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameST. JOSEPH'S MEDICAL CENTER
Location Address110 3RD ST. SHackensack, MN 56452-0485
Mailing Address6501 City West PkwyEden Prairie, MN 55344-3248 · (952) 653-2525
Organization SubpartYes
Authorized OfficialJani WieboltPresident · (218) 828-8764
Enumeration DateJanuary 28, 2011
NPI 1083910699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
110 3RD ST. S, Hackensack, MN 56452

Other Names 1

Doing Business AsEssentia Health St. Joseph's - Hackensack Clinic

Accepted Insurance

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 24D1088668

Essentia Health St Josephs - Hackensack Clinic · Hackensack, MN
Active · expires Sep 30, 2027
CLIA Number24D1088668
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorDanielle L. Ashcroft
Laboratory Phone(218) 675-5044
Laboratory LocationEssentia Health St Josephs - Hackensack Clinic110 3rd St S, Hackensack, MN 56452
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Primary Care)
110 3RD ST. S
HACKENSACK, MN 56452

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 St. Joseph's Medical Center's NPI number?

The NPI number for St. Joseph's Medical Center is 1083910699. It was assigned to this organization in the NPPES registry on January 28, 2011. The provider is doing business as Essentia Health St. Joseph's - Hackensack Clinic.

Where is St. Joseph's Medical Center located?

St. Joseph's Medical Center is located at 110 3rd St. S, Hackensack, MN 56452. The listed phone number is (218) 675-5044.

What is St. Joseph's Medical Center's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does St. Joseph's Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1088668) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St. Joseph's Medical Center accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 37 other insurers list St. Joseph's Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St. Joseph's Medical Center was last updated on January 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.