NPIMap

Organization Active NPI

Ortonville Area Health Services

  • Home Health Agency
  • Ortonville, MN
National Provider Identifier
1013919901
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
359229 Issued in MN
Legal business name
ORTONVILLE AREA HEALTH SERVICES
Practice address
450 Eastvold Ave
Ortonville, MN 56278-1252
Phone
(320) 839-2502
Fax
(320) 839-4105
NPI assigned
Aug 11, 2005
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Mr. David Rogers
Title
Administrator
Phone
(320) 839-2502

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 359229 MN Primary
Adult Care Home Facility 311ZA0620X 328367 MN

Addresses

Primary practice location

450 Eastvold Ave
Ortonville, MN 56278-1252

Mailing address

450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (320) 839-2502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061006000569 MN Part A Provider - Home Health Agency 2365448768 Practice locations: Ortonville, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013919901. Details of each certification follow.

Home health agency certification: CCN 247203

Legal name
ORTONVILLE AREA HEALTH SERVICES
Doing business as
ORTONVILLE AREA HEALTH SERVICES HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 28, 1985
Last certification
Aug 15, 2018
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
201 Mark Drive
Ortonville, MN 56278

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ortonville Area Health Services Home Health AgencyCCN 247203 · All quality measures
Ownership
Government Operated
Certified
Aug 28, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Ortonville Area Health8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Allan E Ross Individual Corporate OfficerCeo Aug 31, 2022
Shane Michael Ayres Individual Corporate OfficerCfo Oct 9, 2018
W-2 Managing EmployeeCfo Oct 9, 2018
City of Ortonville Organization, Ortonville, MN 5% Or Greater Indirect Ownership Interest Jan 1, 1952 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1013919901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781252",
            "telephone_number": "320-839-2502",
            "fax_number": "320-839-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781252",
            "telephone_number": "320-839-2502",
            "fax_number": "320-839-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTONVILLE AREA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-839-2502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "359229",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "328367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ortonville, MN

Sources for this page

Verify at the official NPI Registry.