1. Home
  2. Directory
  3. Minnesota
  4. Saint Paul
  5. Pediatrics
  6. NPI Profile

ST CATHERINE UNIVERSITY HEALTH AND WELLNESS CENTER
NPI 1891016481
Pediatrics - Adolescent Medicine in Saint Paul, MN

Active since June 17, 2010CLIA 24D0667911 · Waiver
2004 RANDOLPH AVE, MAIL #4112, SAINT PAUL, MN 55105(651) 690-6714(651) 690-6188 Get Directions Write a Review

NPPES record last updated: June 17, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About St Catherine University Health And Wellness Center NPPES

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

ST CATHERINE UNIVERSITY HEALTH AND WELLNESS CENTER (NPI 1891016481) is a healthcare organization registered as an adolescent medicine in Saint Paul, Minnesota and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through November 6, 2027 and lists Amy M Kelly, Md, as its authorized official.

NPPES Registry Identity

NPI1891016481
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameST CATHERINE UNIVERSITY
Location Address2004 RANDOLPH AVE, MAIL #4112Saint Paul, MN 55105-1750
Mailing Address2004 Randolph Ave, Mail #4112Saint Paul, MN 55105-1750 · (651) 690-6714 · Fax (651) 690-6188
Phone(651) 690-6714
Fax(651) 690-6188
Organization SubpartNo
Authorized OfficialAmy M KellyMd · (651) 690-6714
Enumeration DateJune 17, 2010
✔ NPI 1891016481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in MN · 40727
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
2004 RANDOLPH AVE, Saint Paul, MN 55105
Open in Google Maps ↗

Other Names 1

Doing Business AsSt Catherine University Health And Wellness Center

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

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 24D0667911

St Catherine University Health & Wellness Clinic · Saint Paul, MN
Active · expires Nov 6, 2027
CLIA Number24D0667911
Laboratory TypeSchool/Student Health Service
Certificate Effective DateNovember 7, 2025
Certificate Expiration DateNovember 6, 2027
Laboratory DirectorLauren Peterson
Laboratory Phone(651) 690-6714
Laboratory LocationSt Catherine University Health & Wellness Clinic2004 Randolph Ave Butler Center, Saint Paul, MN 55105
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

DEBORAH ANN MADANAYAKE PT
Physical Therapist
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (651) 690-7737
DANG HONG PHAM
Student in an Organized Health Care Education/Training Program
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (651) 690-6000
MACIEJ SKORUPSKI PA
Student in an Organized Health Care Education/Training Program
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (507) 312-1545
CAROLYN ZIEBOL
Physician Assistant
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (800) 945-4599
VANESSA HARGENS
Registered Nurse (Medical-Surgical)
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (651) 690-6000
MEGHAN LEE REARDON PA-C
Physician Assistant
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (651) 690-6000
MICAELA FLORES
Student in an Organized Health Care Education/Training Program
2004 RANDOLPH AVE
SAINT PAUL, MN 55105
Ramsey County (651) 690-6000
MRS. ABBY EMMA MARIE EDGAR ATC/R
Specialist/Technologist (Athletic Trainer)
2004 RANDOLPH AVE, F-18
SAINT PAUL, MN 55105
Ramsey County (651) 690-6730

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 St Catherine University's NPI number?

The NPI number for St Catherine University is 1891016481. It was assigned to this organization in the NPPES registry on June 17, 2010. The provider is doing business as St Catherine University Health And Wellness Center.

Where is St Catherine University located?

St Catherine University is located at 2004 Randolph Ave Mail #4112, Saint Paul, MN 55105. The listed phone number is (651) 690-6714.

What is St Catherine University's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does St Catherine University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0667911) is associated with this NPI, valid through November 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Catherine University accept?

Health plans from Medica list St Catherine University as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Catherine University was last updated on June 17, 2010. 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.