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STILLWATER MEDICAL GROUP
NPI 1558350488
Family Medicine in Stillwater, MN

Active since October 13, 2005CLIA Certified · 2 labs
1500 CURVE CREST BLVD W, STILLWATER, MN 55082(651) 439-1234(651) 351-0827 Get Directions Write a Review

NPPES record last updated: October 18, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stillwater Medical Group NPPES

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

STILLWATER MEDICAL GROUP (NPI 1558350488), doing business as Stillwater Medical Group, Pa, is a healthcare organization registered as a family medicine in Stillwater, Minnesota and active in the NPI registry since October 2005. The organization holds 2 active CLIA laboratory certificates and lists Kirk Nybakken, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1558350488
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSTILLWATER MEDICAL GROUP
Location Address1500 CURVE CREST BLVD WStillwater, MN 55082-6040
Mailing Address1500 Curve Crest Blvd WStillwater, MN 55082-6040 · (651) 439-1234 · Fax (651) 351-0827
Phone(651) 439-1234
Fax(651) 351-0827
Organization SubpartNo
Authorized OfficialKirk NybakkenDirector Of Finance · (651) 275-3302
Enumeration DateOctober 13, 2005
Last NPPES UpdateOctober 18, 2011
✔ NPI 1558350488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPreventive Medicine · Occupational MedicineTaxonomy 2083X0100X
Also ListedSurgeryTaxonomy 208600000X
Also ListedPodiatristTaxonomy 213E00000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedAudiologistTaxonomy 231H00000X
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X
Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedAdvanced Practice MidwifeTaxonomy 367A00000X
1500 CURVE CREST BLVD W, Stillwater, MN 55082
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Other Names 1

Former Legal Business NameStillwater Medical Group, Pa

Other Identifiers 7

Medicare PINDC9027MN
Other5439670003MN · Medicare Nsb
Medicaid32882900WI
Medicare PINC03865MN
Medicaid32834400WI
Medicare PIN56150WI
Medicaid802128700MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 24D0998210

Stillwater Medical Group · Stillwater, MN
Active · expires Apr 8, 2028
CLIA Number24D0998210
Laboratory TypePhysician Office
Certificate Effective DateApril 9, 2026
Certificate Expiration DateApril 8, 2028
Laboratory DirectorJonathan Sellman
Laboratory Phone(651) 439-1234
Laboratory LocationStillwater Medical Group1500 Curve Crest Blvd, Stillwater, MN 55082
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D0935436

Stillwater Medical Group Greeley Clinic · Stillwater, MN
Active · expires Apr 30, 2028
CLIA Number24D0935436
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorLaura A. Dean
Laboratory Phone(651) 275-3311
Laboratory LocationStillwater Medical Group Greeley Clinic921 South Greeley Street, Stillwater, MN 55082
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

ALISON GARDNER PA-C
Physician Assistant
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
MRS. KATELYN STAHNKE ATC
Specialist/Technologist (Athletic Trainer)
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
DR. STEPHEN MARK SCALLON MD
Pediatrics
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
DR. ERIC GRANT MEINBERG M.D.
Orthopaedic Surgery (Orthopaedic Trauma)
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
MR. EVAN ROBERT OLSON DPT
Physical Therapist
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
LAURA J MEYER NP
Nurse Practitioner
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
MARA LOGERQUIST M.S., CF-SLP
Speech-Language Pathologist
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234
CYNTHIA G. GOETZ PA-C
Physician Assistant (Surgical)
1500 CURVE CREST BLVD W
STILLWATER, MN 55082
Washington County (651) 439-1234

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 Stillwater Medical Group's NPI number?

The NPI number for Stillwater Medical Group is 1558350488. It was assigned to this organization in the NPPES registry on October 13, 2005. The provider was formerly known as Stillwater Medical Group, PA.

Where is Stillwater Medical Group located?

Stillwater Medical Group is located at 1500 Curve Crest Blvd W, Stillwater, MN 55082. The listed phone number is (651) 439-1234.

What is Stillwater Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Stillwater Medical Group hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Stillwater Medical Group was last updated on October 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.