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MCCORNELL COURT
NPI 1700115003
Assisted Living Facility in Parkers Prairie, MN

Active since December 15, 2009CLIA 24D2232050 · Waiver
122 NO. MCCORNELL AVENUE, PARKERS PRAIRIE, MN 56361(218) 338-4671(218) 338-5917 Get Directions Write a Review

NPPES record last updated: December 22, 2009. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mccornell Court NPPES

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

MCCORNELL COURT (NPI 1700115003) is a healthcare organization registered as an assisted living facility in Parkers Prairie, Minnesota and active in the NPI registry since December 2009. The organization holds a CLIA Waiver certificate valid through August 9, 2027 and lists Paul C. Baer, Administrator, as its authorized official.

NPPES Registry Identity

NPI1700115003
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameMCCORNELL COURT
Location Address122 NO. MCCORNELL AVENUEParkers Prairie, MN 56361
Mailing AddressP.o. Box 30Parkers Prairie, MN 56361 · (218) 338-4671 · Fax (218) 338-5917
Phone(218) 338-4671
Fax(218) 338-5917
Organization SubpartYesParent: St. Williams Living Center
Authorized OfficialPaul C. BaerAdministrator · (218) 338-4671
Enumeration DateDecember 15, 2009
Last NPPES UpdateDecember 22, 2009
✔ NPI 1700115003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 346068
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
122 NO. MCCORNELL AVENUE, Parkers Prairie, MN 56361
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Other Identifiers 2

Medicare UPIN245588
Medicaid887342900MN

CLIA Laboratory Certificates CMS CLIA

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 24D2232050

Mccornell Court · Parkers Prairie, MN
Active · expires Aug 9, 2027
CLIA Number24D2232050
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 10, 2025
Certificate Expiration DateAugust 9, 2027
Laboratory DirectorTimothy R. Kelly
Laboratory Phone(218) 338-1001
Laboratory LocationMccornell Court122 N Mccornell Ave, Parkers Prairie, MN 56361
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Mccornell Court's NPI number?

The NPI number for Mccornell Court is 1700115003. It was assigned to this organization in the NPPES registry on December 15, 2009.

Where is Mccornell Court located?

Mccornell Court is located at 122 No. Mccornell Avenue, Parkers Prairie, MN 56361. The listed phone number is (218) 338-4671.

What is Mccornell Court's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Mccornell Court hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2232050) is associated with this NPI, valid through August 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mccornell Court was last updated on December 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.