STILLWATER MEDICAL GROUP MAHTOMEDI
NPI 1861742918
Family Medicine in Saint Paul, MN

NPI Status: Active since September 17, 2012

Contact Information

700 WILDWOOD RD
SAINT PAUL, MN
ZIP 55115
Phone: (651) 439-1234
Fax: (651) 275-3325

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  • Organization
  • Family Medicine
  • CLIA Number: 24D0673917
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About STILLWATER MEDICAL GROUP MAHTOMEDI

This page provides the complete NPI Profile along with additional information for Stillwater Medical Group Mahtomedi, a primary care provider established in Saint Paul, Minnesota operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1861742918 assigned on September 2012. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. Stillwater Medical Group Mahtomedi operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Stillwater Medical Group Mahtomedi. The authorized official of this NPI record is Mr. Ross Bullard (Director Of Finance)

NPI
1861742918
Provider Legal Name
STILLWATER MEDICAL GROUP
Other Organization Name
STILLWATER MEDICAL GROUP MAHTOMEDI
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
700 WILDWOOD RD SAINT PAUL, MN 55115
Location Phone
(651) 439-1234
Location Fax
(651) 275-3325
Mailing Address
1500 CURVE CREST BLVD STILLWATER, MN 55082
Mailing Phone
(651) 439-1234
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-17-2012
Last Update Date
07-29-2013
Code Navigator

A primary care provider (PCP) like Stillwater Medical Group Mahtomedi sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

 
2213E00000XPodiatric Medicine & Surgery Service Providers

Podiatrist

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

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

MR. ROSS BULLARD

Authorized Official Title
DIRECTOR OF FINANCE
Authorized Official Phone
(651) 439-1234

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
24D0673917
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
DAWN HOVER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Stillwater Medical Group Mahtomedi to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1861742918, 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
8
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
1
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
4
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
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 6 → 12 → 3 7 → 14 → 5 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 1 + 2 + 1 + 1 + 4 + 4 + 4 + 9 + 2 + 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 1861742918.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861742918, enumerated as an "organization" on September 17, 2012.

The provider is located at 700 WILDWOOD RD SAINT PAUL, MN 55115 and the phone number is (651) 439-1234.

Family Medicine with taxonomy code 207Q00000X.