OrganizationActive
Columbia Park Medical Group, PA
NPI 1417056698 · Clinic Pharmacy · Andover, MN
Columbia Park Medical Group, PA is a Clinic Pharmacy organization in Andover, MN (NPI 1417056698).
Provider details
- NPI number
- 1417056698
- Entity type
- Organization
- Primary specialty
- Clinic PharmacySuppliers
- Organization subpart
- No
- Authorized official
- John Weir, Executive Director(763) 586-5877
- License
- 261566-8 (MN)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13819 Hanson Blvd Nw
Suite 100
Andover, MN 55304-7608
Phone: (763) 862-4445
Fax: (763) 862-4465
Street-level locationGet directions
Mailing address
6401 University Ave Ne
Fridley, MN 55432-4341
Other names (DBA / former)
- Other name
- Cpmg-Andover Pharmacy
Registry dates
- Enumerated
- 2006-09-22
- Last updated
- 2023-03-07
Frequently asked questions
- What is Columbia Park Medical Group, PA's NPI number?
- Columbia Park Medical Group, PA's National Provider Identifier (NPI) is 1417056698, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Columbia Park Medical Group, PA?
- Columbia Park Medical Group, PA is classified in the NPPES registry as Clinic Pharmacy (Suppliers).
- Where is Columbia Park Medical Group, PA located?
- Columbia Park Medical Group, PA's practice location on file with NPPES is 13819 Hanson Blvd Nw, Andover, MN 55304-7608.
- What is Columbia Park Medical Group, PA's phone number?
- The practice phone number listed in the NPPES registry for Columbia Park Medical Group, PA is (763) 862-4445.
- Who is the authorized official for Columbia Park Medical Group, PA?
- The authorized official listed on Columbia Park Medical Group, PA's NPPES record is John Weir, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Columbia Park Medical Group, PA's NPI active?
- Yes — Columbia Park Medical Group, PA's NPI (1417056698) is active in the NPPES registry as of the last update on 2023-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.