Provider Demographics
NPI:1851905251
Name:NEXUS
Entity Type:Organization
Organization Name:NEXUS
Other - Org Name:SERCC-NEXUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-226-8397
Mailing Address - Street 1:2121 CAMPUS DR SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4744
Mailing Address - Country:US
Mailing Address - Phone:763-551-8640
Mailing Address - Fax:
Practice Address - Street 1:2121 CAMPUS DR SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4744
Practice Address - Country:US
Practice Address - Phone:763-551-8640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FEIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-02
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental IllnessGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11-1111111OtherFEE FOR SERVICE
MN22-2222222Medicaid