OrganizationActive
Countryside Medical Clinic P.L.L.C
NPI 1730072075 · Clinic/Center · Montevideo, MN
Provider details
- NPI number
- 1730072075
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Wyatt Haugen, Clinic Owner(320) 226-5416
Specialties & taxonomies
Ambulatory Health Care Facilities
- Infusion Therapy Clinic/Center261QI0500X
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr 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
416 N 1st St Ste 2
Montevideo, MN 56265-1408
Phone: (320) 226-5416
Street-level locationGet directions
Mailing address
Po Box 27
Montevideo, MN 56265-0027
Other names (DBA / former)
- Doing business as
- Countryside IV Lounge and Wellness
- Doing business as
- Countryside IV Lounge and Wellness
- Doing business as
- Countryside Medical Clinic P.L.L.C
Registry dates
- Enumerated
- 2025-06-03
- Last updated
- 2025-10-10
- Certified
- 2025-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.