NPIMap

Organization Active NPI

Ridgeview Medical Center

  • Community Based Hospice Care Agency
  • Waconia, MN
National Provider Identifier
1013045350
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
333821 Issued in MN
Legal business name
RIDGEVIEW MEDICAL CENTER
Practice address
501 South Maple St
Suite 1
Waconia, MN 55387-0096
Phone
(952) 442-6030
Fax
(952) 442-6542
NPI assigned
Feb 28, 2007
Organization subpart
Yes
Parent organization
RIDGEVIEW MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael J Phelps
Title
President/Ceo
Phone
(952) 442-2191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 333821 MN Primary

Addresses

Primary practice location

501 South Maple St
Suite 1
Waconia, MN 55387-0096

Mailing address

501 South Maple St
Suite 1
Waconia, MN 55387-0096
Phone (952) 442-6030

Other identifiers 1

IdentifierTypeStateIssuer
783590600MedicaidMN

Other names 1

  • Ridgeview Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000228 MN Part A Provider - Hospice 9234041997 Practice locations: Waconia, MN

Hospice certification: CCN 241567

Legal name
RIDGEVIEW MEDICAL CENTER
Doing business as
RIDGEVIEW HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 27, 1997
Last certification
Oct 4, 2018
Ownership / control type
Non-Profit - Other
Organization structure
OtherNon-profit
Enrollment address
501 S Maple St
Ste 1
Waconia, MN 55387-0096

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Ridgeview HospiceCCN 241567
Ownership
Non-Profit
Certified
Aug 27, 1997
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ridgeview Home Care2 organizations share this tax ID, including this one
Part of
Ridgeview Medical Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 13

Organizations listed as members of this organization in the National Provider Directory.

View all 13

Locations

113 W Main St
Waconia, MN 55387
Phone (855) 454-2463

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Theresa J Dalen Individual Corporate Director Feb 22, 2015
Kristine Lingle Individual Operational/Managerial ControlAdministrator Jul 1, 2020
Heather Reighard Individual Corporate DirectorBoard Director Jan 1, 2022
Brian S Mark Individual Corporate Director Feb 22, 2015
Michael Schuler Individual Corporate DirectorBoard Director Jan 1, 2022
Christopher Bielke Individual W-2 Managing EmployeeManager of Payer Strategy Jun 20, 2022
Julie a Osterberg Individual Corporate DirectorBoard Director Jan 1, 2022
David Kirsch Individual Corporate Director Jan 1, 2022
Ben C Nielsen Individual Corporate DirectorChief Operating Officer Jun 24, 2016
Michael J Phelps Individual Corporate DirectorChief Executive Officer Jan 1, 2012
Jeffrey T Nelson Individual Corporate Director May 18, 2009
Erin P Emerson Egginton Individual W-2 Managing EmployeeMD; Jun 1, 2025
Kristin Marie Kirsch Individual Corporate DirectorMedical Director Mar 1, 2024
Brent K Wordelman Individual Corporate OfficerChief Financial Officer Apr 20, 2026
Van Colson Individual Corporate DirectorBoard Director Jan 1, 2022
Stuart Groninga Individual Corporate DirectorBoard Director Jan 1, 2022
Aaron a Bloomquist Individual Corporate DirectorChief Financial Officer Jan 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Minnesota Valley Health Center IncLe Sueur, MN, CCN 241375 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2016
Minnesota Valley Health Center IncLe Sueur, MN, CCN 24Z375 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2016
Ridgeview Sibley Medical CenterArlington, MN, CCN 24Z311 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Sibley Medical CenterArlington, MN, CCN 241311 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Winthrop ClinicWinthrop, MN, CCN 243430 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Gaylord ClinicGaylord, MN, CCN 243429 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Arlington ClinicArlington, MN, CCN 243428 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 21

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1013045350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SOUTH MAPLE ST",
            "address_2": "SUITE 1",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553870096",
            "telephone_number": "952-442-6030",
            "fax_number": "952-442-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SOUTH MAPLE ST",
            "address_2": "SUITE 1",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553870096",
            "telephone_number": "952-442-6030",
            "fax_number": "952-442-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEVIEW MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIDGEVIEW MEDICAL CENTER",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "952-442-2191"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MN",
            "license": "333821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "783590600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeview Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ridgeview Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.