Ortonville Area Health Services
Organization Active NPI Home Health Agency · Ortonville, MN
NPI 1013919901 · NPPES record last updated Nov 9, 2015
Key facts
- NPI
- 1013919901
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 359229 (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
- Organization subpart
- No
Authorized official
- Name
- Mr. David Rogers
- Title
- Administrator
- Phone
- (320) 839-2502
Owners & managing parties with NPI records 1
-
Allan E Ross, MD
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 7
Facilities with the same owner 3
Practitioners 12
-
Susan M Andersen, MD
-
Grant Wade Botker, M.D.
-
Kiana Conrad, CNP
-
Tracy Lynn Dozak, NP-C
-
Sarah Fischer, MD
-
Stacy Ann Grossman, DNP
-
Isaac Knutson, PA-C
-
Amanda McMahon, MD
Medicare Care Compare: Home health agency
- Listed as
- Ortonville Area Health Services Home Health Agency
- Ownership
- Government Operated
- Certified
- Aug 28, 1985
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
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
- Other · Non-profit
- Enrollment address
- 201 Mark Drive
Ortonville, MN 56278
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Allan E Ross |
Corporate Officer |
Aug 31, 2022 | |
| Shane Michael Ayres |
Corporate Officer |
Oct 9, 2018 | |
| W-2 Managing Employee |
Oct 9, 2018 | ||
| City of Ortonville |
5% Or Greater Indirect Ownership Interest | Jan 1, 1952 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061006000569 | MN | Part a Provider - Home Health Agency | 2365448768 | Practice locations: Ortonville, MN |
National Provider Directory
- Tax ID family
- Ortonville Area Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 359229 | MN | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790AOR | Other | MN | BLUE CROSS OF MN |
Other providers in Ortonville, MN
- Sherry Miller
- Twila Johanna Mursu
- Amber Rose Dybdal Nielsen Olson
- Northside Medical Center, PLC
- Occupro Inc.
- Ortonville Area Health Services
- Ortonville Area Health Services
- Ortonville Area Health Services
- Ortonville Area Health Services
- Ortonville Area Health Services
All providers in Ortonville, MN · Home Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.