MBH-MN MEDICAL CLINIC PA
Complete NPI Record 1922586270
Clinic/Center in New Brighton, MN
Active since July 30, 2018
Complete NPI Dataset
This page contains the complete raw NPPES record for Mbh-Mn Medical Clinic Pa (NPI 1922586270), a clinic/center organization in New Brighton, MN. All 30 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1922586270 Field 1/30
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/30
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/30
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: MBH-MN MEDICAL CLINIC PA Field 4/30
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: 550 MAIN ST # 190 Field 5/30
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: NEW BRIGHTON Field 6/30
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MN Field 7/30
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 551123271 Field 8/30
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/30
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6124542046 Field 10/30
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 550 MAIN ST STE 260 Field 11/30
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: NEW BRIGHTON Field 12/30
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MN Field 13/30
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 551123273 Field 14/30
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 15/30
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6123267558 Field 16/30
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: LILE Field 19/30
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: BUD Field 20/30
- The first name of the authorized official.
- Authorized Official Title or Position: OWNER/MEDICAL DIRECTOR Field 21/30
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6122327558 Field 22/30
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 261Q00000X Field 23/30
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 24/30
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: ========= Field 25/30
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 26/30
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: MN Field 27/30
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: EIN NUMBER Field 28/30
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: N Field 29/30
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Credential Text: MD Field 30/30
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
Secondary Practice Locations 24
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
135 Colorado St E
Location 1/24Saint Paul, MN 55107-2244 · Phone (651) 489-7740
109 N Shore Dr
Location 2/24Waverly, MN 55390-5517 · Phone (763) 658-5800
7300 Estes Ave SW
Location 3/24Waverly, MN 55390-8432 · Phone (763) 658-5800
2480 S County Road 45
Location 4/24Owatonna, MN 55060-5113 · Phone (612) 454-2130
3329 University Ave SE
Location 5/24Minneapolis, MN 55414-3325 · Phone (612) 454-2340
2807 Brookdale Dr
Location 6/24Brooklyn Park, MN 55444-1844 · Phone (763) 237-9898
6043 Hudson Rd Ste 220
Location 7/24Woodbury, MN 55125-1033 · Phone (651) 925-8200
2215 S 6th St
Location 8/24Brainerd, MN 56401-5549 · Phone (218) 454-1010
3470 Washington Dr Ste 165
Location 9/24Eagan, MN 55122-3517 · Phone (651) 454-2833
1821 University Ave W Ste 385
Location 10/24Saint Paul, MN 55104-2872 · Phone (651) 647-0095
11900 Wayzata Blvd Ste 100
Location 11/24Minnetonka, MN 55305-2018 · Phone (612) 454-2102
1825 Curve Crest Blvd W Ste 103
Location 12/24Stillwater, MN 55082-6054 · Phone (651) 351-9325
320 Sunrise Dr Ste B
Location 13/24Saint Peter, MN 56082-1353 · Phone (507) 931-0918
19230 Evans St NW Ste 203
Location 14/24Elk River, MN 55330-1574 · Phone (612) 248-1455
104 S 4th St
Location 15/24Olivia, MN 56277-1589 · Phone (320) 400-0001
1680 Airport Rd N
Location 16/24Worthington, MN 56187-3500 · Phone (507) 376-3916
17305 Meadow Creek Lane
Location 17/24Pine City, MN 55063 · Phone (763) 444-4838
1706 University Ave W
Location 18/24Saint Paul, MN 55104-3614 · Phone (651) 645-3661
4800 48th St NE
Location 19/24Rochester, MN 55906-2009 · Phone (507) 289-2753
1609 Jackson St
Location 20/24Saint Paul, MN 55117-3917 · Phone (651) 454-2016
1111 Gateway Dr NE
Location 21/24East Grand Forks, MN 56721-2620 · Phone (218) 793-0420
140 Quail St
Location 22/24Mahtomedi, MN 55115-1941 · Phone (651) 429-2311
11400 Julianne Ave N
Location 23/24Stillwater, MN 55082-9436 · Phone (651) 426-3300
114 N Holcombe Ave
Location 24/24Litchfield, MN 55355-2210 · Phone (320) 693-2461
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