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CENTRACARE CLINIC SOUTHWEST LLC
NPI 1174106264
Clinic/Center - Multi-Specialty in Willmar, MN

Active since May 05, 2021
101 WILLMAR AVE SW, WILLMAR, MN 56201(320) 231-5000 Get Directions Write a Review

NPPES record last updated: April 18, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 18, 2022, May 5, 2021 (2 updates tracked since 2021).

About Centracare Clinic Southwest Llc NPPES

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

CENTRACARE CLINIC SOUTHWEST LLC (NPI 1174106264) is a healthcare organization registered as a multi-specialty in Willmar, Minnesota and active in the NPI registry since May 2021. The organization lists Michael Blair, Cfo, as its authorized official.

NPPES Registry Identity

NPI1174106264
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameCENTRACARE CLINIC SOUTHWEST LLC
Location Address101 WILLMAR AVE SWWillmar, MN 56201-3556
Mailing Address1200 6th Ave NSaint Cloud, MN 56303-2735 · (320) 251-2700
Phone(320) 231-5000
Organization SubpartNo
Authorized OfficialMichael BlairCfo · (320) 255-5665
Enumeration DateMay 5, 2021
Last NPPES UpdateApril 18, 20222 updates tracked since enumeration
NPPES CertifiedApril 18, 2022
✔ NPI 1174106264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
101 WILLMAR AVE SW, Willmar, MN 56201
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 10

Medicare supplier enrollment and the product categories Centracare - Willmar Clinic carries, from the Medicare DMEPOS supplier directory.

Centracare - Willmar Clinic

DMEPOS supplier · Willmar, MNOperated by Centracare Clinic Southwest LLC
✔

Accepts Medicare assignment

Centracare - Willmar Clinic agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20405549
Medicare Participant SinceJune 15, 2021
Supplier Location101 Willmar Ave SWWillmar, MN 56201
Phone(320) 231-5000
Provider TypePhysician – Physical And Rehabilitation · Multi-Specialty - Physician
Supplier Specialties
Optometrist

Medicare Product Categories

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
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

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

MS. AMBER ERIN JOHNSON WHNP
Nurse Practitioner
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
FRANCES ANNE ANTKOWIAK APNP
Nurse Practitioner
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. PATRICIA A DAQUILA MD
Internal Medicine
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. MICHAEL J HODAPP MD
Pediatrics
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. RAYMOND J MELLEMA MD
Family Medicine
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. LACHLAN C SMITH MD
Obstetrics & Gynecology
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. ROBERT M KAISER MD
Family Medicine
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000
DR. GLENN C BUCHANAN MD
Obstetrics & Gynecology
101 WILLMAR AVE SW
WILLMAR, MN 56201
Kandiyohi County (320) 231-5000

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 Centracare Clinic Southwest LLC's NPI number?

The NPI number for Centracare Clinic Southwest LLC is 1174106264. It was assigned to this organization in the NPPES registry on May 5, 2021.

Where is Centracare Clinic Southwest LLC located?

Centracare Clinic Southwest LLC is located at 101 Willmar Ave SW, Willmar, MN 56201. The listed phone number is (320) 231-5000.

What is Centracare Clinic Southwest LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Centracare Clinic Southwest LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Centracare - Willmar Clinic accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Centracare Clinic Southwest LLC accept?

Health plans from HealthPartners, Medica and Sanford Health Plan list Centracare Clinic Southwest LLC 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 Centracare Clinic Southwest LLC was last updated on April 18, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.