Centracare Clinic
Centracare Clinic is a healthcare organization registered as Multi-Specialty Clinic/Center in Saint Cloud, MN, holding Type 2 (organization) NPI 1407858020 since 2005. The authorized official on file is Michael Blair, Sr Vp & Cfo.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1407858020 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Centracare Clinic |
| Other name | <Unavail> |
| Parent organization | Centracare Clinic |
| Practice address | 1900 CENTRACARE CIR, CENTRACARE CLINIC HEALTH PLAZA, Saint Cloud, MN, 56303 |
| Phone | 3202522422 |
| Enumeration date | 2005-08-12 |
| Last updated in NPPES | 2020-11-19 |
Authorized official
| Name | Michael Blair |
|---|---|
| Title | Sr Vp & Cfo |
| Phone | 3202555665 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM1300X | Multi-Specialty Clinic/Center | Secondary | 411086657 | MN |
| 261QU0200X | Urgent Care Clinic/Center | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 498R1CE | Other | — | BCBS |
| 170317 | Other | — | UCARE |
| 35580 | Other | — | HEALTH PARTNERS |
| 052720300 | Medicaid | MN | — |
| NA356 | Other | — | PREF ONE |
| 052720303 | Medicaid | MN | — |
| 98-00211 | Other | — | MEDICA |
Copy-ready billing details
Provider: Centracare Clinic NPI: 1407858020 Taxonomy: 261QM1300X (Multi-Specialty Clinic/Center) Address: 1900 CENTRACARE CIR, CENTRACARE CLINIC HEALTH PLAZA, Saint Cloud, MN, 56303
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1225030844 | Centracare Clinic | Organization | Multi-Specialty Clinic/Center | Saint Cloud, MN |
| 1487644134 | Jeanne Notsch | Individual | Adult Health Nurse Practitioner | Saint Cloud, MN |
| 1992795652 | Douglas Watkins | Individual | Geriatric Medicine (Family Medicine) Physician | Saint Cloud, MN |
| 1366432015 | Kathryn Mechelke | Individual | Family Medicine Physician | Saint Cloud, MN |
| 1982694659 | Paul Dorsher | Individual | Gastroenterology Physician | Saint Cloud, MN |
| 1679563274 | Peter Nelson | Individual | Gastroenterology Physician | Saint Cloud, MN |
| 1528058930 | Scot Hutton | Individual | Gastroenterology Physician | Saint Cloud, MN |
| 1831189240 | Mark Holm | Individual | Endocrinology, Diabetes & Metabolism Physician | Saint Cloud, MN |
Verify this record
Cross-check NPI 1407858020 against the authoritative CMS record: view Centracare Clinic on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Centracare Clinic located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-11-19.