Southern Cities Clinic - Medicare Primary Care in Faribault, MN

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Southern Cities Clinic is a medicare enrolled primary clinic (General Practice) in Faribault, Minnesota. The current practice location for Southern Cities Clinic is 400 4th St Nw, Faribault, Minnesota. For appointments, you can reach them via phone at (507) 384-6830. The mailing address for Southern Cities Clinic is 3200 Labore Rd Ste 104, Vadnais Heights, Minnesota and phone number is () -.

Southern Cities Clinic is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1437218740. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (507) 384-6830.

Contact Information

Southern Cities Clinic
400 4th St Nw
Faribault
MN 55021-5031
(507) 384-6830
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameSouthern Cities Clinic
SpecialityGeneral Practice
Location400 4th St Nw, Faribault, Minnesota
Authorized Official Name and PositionMelissa Ells (AMBULATORY CARE EXECUTIVE DIRECTOR)
Authorized Official Contact6515397200
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Southern Cities Clinic
3200 Labore Rd Ste 104
Vadnais Heights
MN 55110-5186

Ph: () -		Southern Cities Clinic
400 4th St Nw
Faribault
MN 55021-5031

Ph: (507) 384-6830

NPI Details:

NPI Number1437218740
Provider Enumeration Date12/06/2006
Last Update Date01/28/2026

Medicare PECOS Information:

Medicare PECOS PAC ID7517912991
Medicare Enrollment IDO20050318000140

Medical Identifiers

Medical identifiers for Southern Cities Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1437218740NPI-NPPES
496053000MedicaidMN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Southern Cities Clinic acts as a billing entity for following providers:
Provider NameCarol J Peitzman
Provider TypePractitioner - Certified Clinical Nurse Specialist (cns)
Provider IdentifiersNPI Number: 1225120991
PECOS PAC ID: 9830148642
Enrollment ID: I20050119000754
Provider NameEve C Berryhill
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1942273461
PECOS PAC ID: 3971553553
Enrollment ID: I20050201000156
Provider NameMaria Harmandayan
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1669664918
PECOS PAC ID: 5991884314
Enrollment ID: I20080509000153
Provider NameAbigail Porter Hestness Houts
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1700947173
PECOS PAC ID: 5799827184
Enrollment ID: I20100614000910
Provider NameMegan Cyrilla Deschene
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1013267079
PECOS PAC ID: 5092956128
Enrollment ID: I20130731000850
Provider NameBryan Ricardo Carleton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902201700
PECOS PAC ID: 3173847530
Enrollment ID: I20161212000003
Provider NameFrederick William Houts
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1518152172
PECOS PAC ID: 7618161290
Enrollment ID: I20180416001493
Provider NameKatherine R Vaughan
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1619350006
PECOS PAC ID: 4284050758
Enrollment ID: I20200813003401
Provider NameKyleeann S Stevens
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1427234475
PECOS PAC ID: 2466869508
Enrollment ID: I20210407002216
Provider NameDaniel O Moegi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508534751
PECOS PAC ID: 2264821610
Enrollment ID: I20211105001387
Provider NameErik Michael Adolphson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1063760742
PECOS PAC ID: 2961937958
Enrollment ID: I20241127003121
Provider NameEllyn Marie Erickson
Provider TypePractitioner - Dentist
Provider IdentifiersNPI Number: 1588319354
PECOS PAC ID: 8921525445
Enrollment ID: I20250508000952

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.