SMART CLINIC
NPI 1699859124
Family Medicine in Fairmont, MN

Active since October 24, 2006
322 S STATE ST, 5 LAKE CENTER DRIVE, FAIRMONT, MN 56031(507) 236-2880 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Smart Clinic NPPES

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

SMART CLINIC (NPI 1699859124) is a healthcare organization registered as a family medicine in Fairmont, Minnesota and active in the NPI registry since October 2006. The organization lists Timothy C Bachenberg, President, as its authorized official.

NPPES Registry Identity

NPI1699859124
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCUSTOM CLINIC, P.A.
Location Address322 S STATE ST, 5 LAKE CENTER DRIVEFairmont, MN 56031-4139
Mailing Address322 S State St, 5 Lake Center DriveFairmont, MN 56031-4139 · (507) 236-2880
Organization SubpartNo
Authorized OfficialTimothy C BachenbergPresident · (507) 236-2880
Enumeration DateOctober 24, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1699859124 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.

322 S STATE ST, Fairmont, MN 56031

Other Names 1

Doing Business AsSmart Clinic

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 5

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

Pharmacy (Community/Retail Pharmacy)
322 S STATE ST, FIVE LAKES CTR
FAIRMONT, MN 56031
Pharmacist
322 S STATE ST
FAIRMONT, MN 56031
Pharmacist
322 S STATE ST
FAIRMONT, MN 56031
Pharmacist
322 S STATE ST, FIVE LAKES CENTRE
FAIRMONT, MN 56031
Pharmacist
322 S STATE ST
FAIRMONT, MN 56031

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 Custom Clinic, P.A.'s NPI number?

The NPI number for Custom Clinic, P.A. is 1699859124. It was assigned to this organization in the NPPES registry on October 24, 2006. The provider is doing business as Smart Clinic.

Where is Custom Clinic, P.A. located?

Custom Clinic, P.A. is located at 322 S State St 5 Lake Center Drive, Fairmont, MN 56031. The listed phone number is (507) 236-2880.

What is Custom Clinic, P.A.'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 Custom Clinic, P.A. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.