| Indian Health Board Of Minneapolis, Inc | |
|
1315 E 24th St Minneapolis MN 55404-3975 | |
| (612) 721-9800 | |
| (612) 721-7870 |
| Full Name | Indian Health Board Of Minneapolis, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1315 E 24th St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Patrick Rock (CEO) |
| Authorized Official Contact | 6127219881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Health Board Of Minneapolis, Inc 1315 E 24th St Minneapolis MN 55404-3975 Ph: (612) 721-9800 | Indian Health Board Of Minneapolis, Inc 1315 E 24th St Minneapolis MN 55404-3975 Ph: (612) 721-9800 |
| NPI Number | 1811999162 |
|---|---|
| Provider Enumeration Date | 06/01/2005 |
| Last Update Date | 01/19/2011 |
| Medicare PECOS PAC ID | 6002727849 |
|---|---|
| Medicare Enrollment ID | O20050825000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811999162 | NPI | - | NPPES |
| 844522200 | Medicaid | MN | |
| 916817600 | Medicaid | MN | |
| 946883800 | Medicaid | MN | |
| 634930700 | Medicaid | MN | |
| 730320300 | Medicaid | MN | |
| 781137300 | Medicaid | MN | |
| 138488100 | Medicaid | MN | |
| 934633300 | Medicaid | MN | |
| 125028100 | Medicaid | MN | |
| 206817600 | Medicaid | MN | |
| 996488600 | Medicaid | MN | |
| 942317600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6115875 (Minnesota) | Primary |
| Provider Name | Mitchell J Lacombe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336144179 PECOS PAC ID: 3375588874 Enrollment ID: I20050624000729 |
| Provider Name | Patrick M Rock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235134354 PECOS PAC ID: 4284633181 Enrollment ID: I20061204000055 |
| Provider Name | Laiel I Baker-dekrey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972826501 PECOS PAC ID: 7517097017 Enrollment ID: I20100609000993 |
| Provider Name | Angela M Erdrich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477583425 PECOS PAC ID: 1052313699 Enrollment ID: I20101007000588 |
| Provider Name | Thomas G Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184973133 PECOS PAC ID: 8527211382 Enrollment ID: I20130104000176 |
| Provider Name | Robin B Young |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467856187 PECOS PAC ID: 0345562096 Enrollment ID: I20141208000889 |
| Provider Name | Jocelyn L Guler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093199226 PECOS PAC ID: 5597070490 Enrollment ID: I20150821013271 |
| Provider Name | Emily R Torell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912317124 PECOS PAC ID: 7810201258 Enrollment ID: I20181024001401 |
| Provider Name | Luz Angelica Salinas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194368191 PECOS PAC ID: 0547697195 Enrollment ID: I20200221000216 |
| Provider Name | Shelia Thorstesons |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366496200 PECOS PAC ID: 1759718919 Enrollment ID: I20200227002070 |
| Provider Name | Tyler Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558955690 PECOS PAC ID: 3870901440 Enrollment ID: I20210420001526 |
| Provider Name | Mary Monica Streater |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1962025924 PECOS PAC ID: 6709275860 Enrollment ID: I20211110001774 |
| Provider Name | David W Henry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962934729 PECOS PAC ID: 0446522288 Enrollment ID: I20220218000855 |
| Provider Name | Justin T Mikesell |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831684539 PECOS PAC ID: 9335485424 Enrollment ID: I20220908000686 |
| Provider Name | Janet L Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730348327 PECOS PAC ID: 7719296193 Enrollment ID: I20230202002191 |
| Provider Name | Christina Garrison-diehn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053766030 PECOS PAC ID: 9032406731 Enrollment ID: I20230208000694 |
| Provider Name | Micah Prairie Chicken |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518640473 PECOS PAC ID: 2264895796 Enrollment ID: I20230830002789 |
| Provider Name | Rosilynn Nicole Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487431177 PECOS PAC ID: 2062866619 Enrollment ID: I20230929002825 |
| Provider Name | Kirsten R Farmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235789314 PECOS PAC ID: 9032565429 Enrollment ID: I20231020001391 |
| Provider Name | Kathleen Alida Herling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356014161 PECOS PAC ID: 9830533306 Enrollment ID: I20240223000752 |
| Provider Name | Milo Wilder Due |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093530883 PECOS PAC ID: 1153858519 Enrollment ID: I20241224000212 |
| Provider Name | Karen Leta Gillespie |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1730725482 PECOS PAC ID: 2567999865 Enrollment ID: I20241227001682 |
Morningstar Wellness Center, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Washington Ave N, Suite 202, Minneapolis, MN 55401 Phone: 612-455-2920 Fax: 612-455-2921 | |
Group Health Plan Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8170 33rd Ave S, Ms 21110q, Minneapolis, MN 55425 Phone: 952-883-7469 Fax: 952-883-5395 | |
Regents Of The University Of Minnesota Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Church St Se, Minneapolis, MN 55455 Phone: 612-625-8400 Fax: 612-677-3211 | |
Corban Health Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5141 36th Ave S, Minneapolis, MN 55417 Phone: 612-644-9047 | |
Fairview Express Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2025 E River Pkwy, Minneapolis, MN 55414 Phone: 612-301-0115 | |
Ams Healing And Wellness Solutions Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Washington Ave N Ofc U2-09, Minneapolis, MN 55401 Phone: 320-282-4023 | |
First Class Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1729 N 2nd St, Minneapolis, MN 55411 Phone: 952-270-5238 |