CENTRACARE CLINIC SOUTHWEST LLC
NPI 1174106264
Clinic/Center - Multi-Specialty in Willmar, MN
NPI Status: Active since May 05, 2021
Contact Information
101 WILLMAR AVE SW
WILLMAR, MN
ZIP 56201
Phone: (320) 231-5000
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 24D0405701
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-22-2027
About CENTRACARE CLINIC SOUTHWEST LLC
This page provides the complete NPI Profile along with additional information for Centracare Clinic Southwest Llc, a provider established in Willmar, Minnesota operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1174106264 assigned on May 2021. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Michael Blair (Cfo)
- NPI
- 1174106264
- Provider Name
- CENTRACARE CLINIC SOUTHWEST LLC
- Entity Type
- Organization
- Location Address
- 101 WILLMAR AVE SW WILLMAR, MN 56201
- Location Phone
- (320) 231-5000
- Mailing Address
- 1200 6TH AVE N SAINT CLOUD, MN 56303
- Mailing Phone
- (320) 251-2700
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-05-2021
- Last Update Date
- 04-18-2022
- Code Navigator
Centracare Clinic Southwest Llc is a medicare supplier with PTAN 20405549 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Orthoses: Custom Fabricated or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Penile Pumps or Ostomy Supplies or Urological Supplies or Prosthetic Lenses: Conventional Contact Lenses or Enteral Equipment and/or Supplies or Parenteral Equipment and/or Supplies or Surgical Dressings.
Location Map
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
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - 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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20405549
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist.
- Provider Type List
- PHYSICIAN – PHYSICAL AND REHABILITATION, MULTI-SPECIALTY - PHYSICIAN.
- Competitive Bidding
- NO
Supplies List
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Penile Pumps -
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Urological Supplies - Catheters, Urinary collection devices
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
- Enteral Equipment and/or Supplies - Enteral infusion pumps, enteral nutrition supply kits
- Parenteral Equipment and/or Supplies - Parenteral infusion pumps, parenteral nutrition supply kits
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
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
- 24D0405701
- Facility Type
- Physician Office
- Certificate Effective Date
- December 23, 2025
- Certificate Expiration Date
- December 22, 2027
- Laboratory Director
- KATIE E. SCHOUWEILER
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Centracare Clinic Southwest Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 1174106264, we treat the final digit (4) 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 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 46 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174106264, enumerated as an "organization" on May 05, 2021.
The provider is located at 101 WILLMAR AVE SW WILLMAR, MN 56201 and the phone number is (320) 231-5000.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: HealthPartners, Medica and Sanford Health Plan. Please consult your insurance carrier or call the provider to verify.
