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ST. CROIX FAMILY MEDICAL CLINIC
NPI 1578680872
Family Medicine in Stillwater, MN

Active since March 23, 2007
5640 MEMORIAL AVE N, SUITE B, STILLWATER, MN 55082(651) 430-1880(651) 430-1323 Get Directions Write a Review

NPPES record last updated: April 30, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About St. Croix Family Medical Clinic NPPES

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

ST. CROIX FAMILY MEDICAL CLINIC (NPI 1578680872) is a healthcare organization registered as a family medicine in Stillwater, Minnesota and active in the NPI registry since March 2007. The organization lists William Henry Tendle, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1578680872
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHSIDE COMMUNITY HEALTH SERVICES, INC.
Location Address5640 MEMORIAL AVE N, SUITE BStillwater, MN 55082-2166
Mailing Address4243 4th Ave SMinneapolis, MN 55409-2113 · (612) 822-9030 · Fax (612) 821-2818
Phone(651) 430-1880
Fax(651) 430-1323
Organization SubpartNo
Authorized OfficialWilliam Henry TendleExecutive Director · (612) 821-2800
Enumeration DateMarch 23, 2007
Last NPPES UpdateApril 30, 2014
✔ NPI 1578680872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

5640 MEMORIAL AVE N, Stillwater, MN 55082
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Other Names 1

Other NameSt. Croix Family Medical Clinic

Other Identifiers 2

Medicaid943170500MN
Medicare PINC00626MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

HEATHER DEJARNETT
Advanced Practice Midwife
5640 MEMORIAL AVE N, SUITE B
STILLWATER, MN 55082
Washington County (651) 430-1880

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 Southside Community Health Services, Inc.'s NPI number?

The NPI number for Southside Community Health Services, Inc. is 1578680872. It was assigned to this organization in the NPPES registry on March 23, 2007. The provider is also known as St. Croix Family Medical Clinic.

Where is Southside Community Health Services, Inc. located?

Southside Community Health Services, Inc. is located at 5640 Memorial Ave N Suite B, Stillwater, MN 55082. The listed phone number is (651) 430-1880.

What is Southside Community Health Services, Inc.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Southside Community Health Services, Inc. was last updated on April 30, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.