Active NPI
St. Otto's Care Center Inc
- Skilled Nursing Facility
- Little Falls, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- PENDING
- Legal business name
- ST. OTTO'S CARE CENTER INC
- Practice address
- 920 4TH St SE
Little Falls, MN 56345-3540 - Phone
- (320) 632-9281
- Fax
- (320) 631-4106
- NPI assigned
- May 13, 2008
- Last updated
- Jun 26, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brian Bernander
- Title
- President
- Phone
- (320) 632-9281
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | PENDING | MN | Primary |
Addresses
Primary practice location
920 4TH St SE
Little Falls, MN 56345-3540
Mailing address
920 4TH St SE
Little Falls, MN 56345-3540
Phone (320) 632-9281
Other names 1
- ST. Otto's Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161116001023 | MN | Part A Provider - Skilled Nursing Facility | 5991084931 | Practice locations: Little Falls, MN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1013184647. Details of each certification follow.
Skilled nursing facility certification: CCN 245257
- Legal name
- ST OTTOS CARE CENTER INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1983
- Last certification
- Nov 8, 2024
- Beds
- 86
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 4, 2016 in MN
- Enrollment address
- 920 4TH St SE
Little Falls, MN 56345-3540 - Nursing home name
- ST OTTOS CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Ottos Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 1, 1983
- Medicare certification status
- Active
- Certified beds
- 86
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0405967 | St Otto's Care Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Danna L Potter | Operational/Managerial Control | Jan 1, 2022 | |
| Adp of the SNF | Jan 1, 2022 | ||
| B2K Communities LLC. | 5% Or Greater Mortgage Interest | Nov 1, 2016 | 100% |
| Adp of the SNF | Nov 1, 2016 | ||
| Adp of the SNF | Nov 20, 2025 | ||
| Kelsi K Nelson - Holien | Operational/Managerial Control | Jan 1, 2023 | |
| Adp of the SNF | Feb 1, 2023 | ||
| Karen Jacobs | Operational/Managerial Control | Nov 1, 2016 | |
| Deanna Primus | Operational/Managerial Control | Nov 1, 2016 | |
| Brian P Bernander | 5% Or Greater Direct Ownership Interest | Aug 4, 2016 | 50% |
| Corporate Officer | Aug 4, 2016 | 50% | |
| Corporate Director | Aug 4, 2016 | 50% | |
| Operational/Managerial Control | Nov 1, 2016 | ||
| Adp of the SNF | Nov 1, 2016 | ||
| Direct Ownership Interest | Nov 1, 2016 | ||
| Krista L Bernander | 5% Or Greater Direct Ownership Interest | Aug 4, 2016 | 50% |
| Corporate Officer | Aug 4, 2016 | 50% | |
| Corporate Director | Aug 4, 2016 | 50% | |
| Operational/Managerial Control | Nov 1, 2016 | ||
| Adp of the SNF | Nov 1, 2016 | ||
| Direct Ownership Interest | Nov 1, 2016 | ||
| Michelle Schuett | Operational/Managerial Control | Jul 23, 2022 | |
| Lisa Udy | Operational/Managerial Control | Dec 1, 2022 | |
| Dorothy Bernardy | Operational/Managerial Control | Nov 1, 2016 | |
| Adp of the SNF | Nov 1, 2016 | ||
| Charlie Eggerth | Operational/Managerial Control | Nov 1, 2016 | |
| Adp of the SNF | Nov 1, 2016 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1992733976
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1992733976
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687737600000",
"number": "1013184647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 4TH ST SE",
"city": "LITTLE FALLS",
"state": "MN",
"postal_code": "563453540",
"telephone_number": "320-632-9281",
"fax_number": "320-631-4106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 4TH ST SE",
"city": "LITTLE FALLS",
"state": "MN",
"postal_code": "563453540",
"telephone_number": "320-632-9281",
"fax_number": "320-631-4106"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. OTTO'S CARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-13",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A",
"authorized_official_last_name": "BERNANDER",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "320-632-9281",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MN",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ST. Otto's Care Center",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "ST. Otto's Care Center",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Little Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.