PARK NICOLLET
NPI 1174975528
Clinic/Center in Maple Grove, MN

NPI Status: Active since July 11, 2016

Contact Information

9555 UPLAND LN N
MAPLE GROVE, MN
ZIP 55369
Phone: (952) 993-1440

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  • Organization
  • Clinic/Center
  • CLIA Number: 24D0960663
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-09-2026

About PARK NICOLLET

This page provides the complete NPI Profile along with additional information for Park Nicollet, a provider established in Maple Grove, Minnesota operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1174975528 assigned on July 2016. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Bernt Helgaas M.d. (Medical Director Park Nicollet Mgrc)

NPI
1174975528
Provider Name
PARK NICOLLET
Entity Type
Organization
Location Address
9555 UPLAND LN N MAPLE GROVE, MN 55369
Location Phone
(952) 993-1440
Mailing Address
7102 OLIVE LN N MAPLE GROVE, MN 55311
Mailing Phone
(763) 494-4686
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-11-2016
Last Update Date
07-11-2016
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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

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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

BERNT HELGAAS M.D.

Authorized Official Title
MEDICAL DIRECTOR PARK NICOLLET MGRC
Authorized Official Phone
(952) 993-1440

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
24D0960663
Facility Type
Physician Office
Certificate Effective Date
October 10, 2024
Certificate Expiration Date
October 09, 2026
Laboratory Director
DR. JASON C. CARVALHO
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Park Nicollet 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 1174975528, 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 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
1
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
7
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
5
Unchanged
Pos 9
2
Doubled → 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 7 → 14 → 5 9 → 18 → 9 5 → 10 → 1 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 4 + 4 + 1 + 8 + 7 + 1 + 0 + 5 + 4 + 24 = 62

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

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1174975528.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Psychologist
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Pediatrics
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Nurse Practitioner (Adult Health)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Nurse Practitioner (Family)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Social Worker (Clinical)
9555 UPLAND LN N, BEHAVIORAL HEALTH, 3RD FLOOR
MAPLE GROVE, MN 55369
Psychologist (Clinical Child & Adolescent)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Psychologist (Clinical)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Dermatology
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Marriage & Family Therapist
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Audiologist
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Physician Assistant
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Physician Assistant (Surgical)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Family Medicine
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Psychologist (Clinical)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Chiropractor
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Family Medicine
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Family Medicine (Sports Medicine)
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Internal Medicine
9555 UPLAND LN N
MAPLE GROVE, MN 55369
Orthopaedic Surgery
9555 UPLAND LN N
MAPLE GROVE, MN 55369

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174975528, enumerated as an "organization" on July 11, 2016.

The provider is located at 9555 UPLAND LN N MAPLE GROVE, MN 55369 and the phone number is (952) 993-1440.

Clinic/Center with taxonomy code 261Q00000X.