NPIMap

Organization Active NPI

Sibley Medical Center

Doing business as Ridgeview Arlington Clinic

  • Rural Health Clinic/Center
  • Arlington, MN
National Provider Identifier
1023078904
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SIBLEY MEDICAL CENTER
Doing business as
Ridgeview Arlington Clinic
Practice address
601 W Chandler St
Arlington, MN 55307-2127
Phone
(507) 964-2271
Fax
(507) 964-8490
NPI assigned
Mar 24, 2006
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X MN Primary

Addresses

Primary practice location

601 W Chandler St
Arlington, MN 55307-2127

Mailing address

601 W Chandler St
P.O. Box 620
Arlington, MN 55307-2127
Phone (507) 964-2271

Other identifiers 1

IdentifierTypeStateIssuer
871403700MedicaidMN

Other names 1

  • Ridgeview Arlington Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140203000569 MN Part A Provider - Rural Health Clinic 3870722499 Practice locations: Arlington, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023078904. Details of each certification follow.

Rural health clinic certification: CCN 243428

Legal name
SIBLEY MEDICAL CENTER
Doing business as
RIDGEVIEW ARLINGTON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2003
Last certification
May 20, 2013
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2014 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1983 in MN
Enrollment address
601 W Chandler St
Arlington, MN 55307-2127
Related CCNs
241311

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Sibley Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

660 3rd St
Gaylord, MN 55334
Phone (507) 237-2933

625 S 4th St
#A
Le Sueur, MN 56058
Phone (507) 593-5920

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Sheri Kumar Individual Corporate DirectorBoard Director Jan 1, 2026
Acacia Meis Individual W-2 Managing EmployeeCredentialing Manager Jun 6, 2022
Diane Bias-Mosel Individual Corporate DirectorBoard Member Jan 1, 2018
Kelly Pierson Individual Corporate Director Jan 1, 2024
Christopher Bielke Individual W-2 Managing EmployeeManager of Payer Strategy Jun 20, 2022
Ben C Nielsen Individual Corporate OfficerCheif Operating Officer Jun 1, 2018
W-2 Managing EmployeeCheif Operating Officer Jun 1, 2018
Michael J Phelps Individual Corporate OfficerCeo Jan 1, 2014
Jeffrey T Nelson Individual Corporate DirectorBoard Member Jan 1, 2023
Nancy Mathwig Individual Corporate DirectorBoard Member Jan 1, 2023
Bertha Woehler Individual Corporate DirectorBoard Member Jan 1, 2023
Brent K Wordelman Individual Corporate OfficerChief Financial Officer Apr 20, 2026
W-2 Managing Employee Oct 1, 2020
James Kreft Individual Corporate DirectorBoard Member Jan 1, 2023
Aaron a Bloomquist Individual Corporate OfficerCfo Oct 1, 2020
W-2 Managing Employee Oct 1, 2020
Ridgeview Medical Center Organization, Waconia, MN Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2014 100%

Owners & managing parties with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1023078904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W CHANDLER ST",
            "address_2": "P.O. BOX 620",
            "city": "ARLINGTON",
            "state": "MN",
            "postal_code": "553072127",
            "telephone_number": "507-964-2271",
            "fax_number": "507-964-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W CHANDLER ST",
            "city": "ARLINGTON",
            "state": "MN",
            "postal_code": "553072127",
            "telephone_number": "507-964-2271",
            "fax_number": "507-964-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIBLEY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "952-442-2191"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871403700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeview Arlington Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ridgeview Arlington Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, MN

Sources for this page

Verify at the official NPI Registry.