NPIMap

Organization Active NPI

St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
National Provider Identifier
1043269798
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
331506 Issued in MN
Legal business name
ST. CLOUD HOSPITAL
Practice address
1406 6TH Ave North
Saint Cloud, MN 56303-1900
Phone
(320) 307-3676
Fax
(320) 656-7009
NPI assigned
May 9, 2006
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Mr. Michael A. Blair
Title
Sr. Vice President & Cfo
Phone
(320) 307-3676

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X 331506 MN Primary

Addresses

Primary practice location

1406 6TH Ave North
Saint Cloud, MN 56303-1900

Mailing address

1406 6TH Ave North
Saint Cloud, MN 56303-1900
Phone (320) 307-3676

Other practice location 1

1564 County Road 134
Saint Cloud, MN 56303-0346
Phone (320) 229-4950

Other identifiers 2

IdentifierTypeStateIssuer
418902MedicaidMN
883747300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20060105000942 MN Part A Provider - Hospital 4880594779 6 other NPIs on this enrollment
Practice locations: Sartell, MN; St Cloud, MN; Saint Cloud, MN; Becker, MN
O20110221000134 MN Part B Supplier - Clinic/Group Practice 4880594779 Receives reassigned benefits from 440 practitioners
13 other NPIs on this enrollment
Practice locations: St Cloud, MN; Waite Park, MN; Sauk Rapids, MN; Sartell, MN; Saint Cloud, MN; Melrose, MN; Albany, MN
O20180516000768 MN Part B Supplier - Intensive Cardiac Rehabilitation 4880594779 Practice locations: Saint Cloud, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043269798. Details of each certification follow.

Hospital certification: CCN 240036

Legal name
ST CLOUD HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 4, 2011
Beds
489 (469 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 12, 1962 in MN
Enrollment address
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Centracare - St. Cloud HospitalCCN 240036 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1586 County Road 134
Saint Cloud, MN 56303
Phone (320) 251-0726

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
Tina SSN May Individual Corporate Director Jul 1, 2025
Michelle Johnson Individual Corporate Director Jul 1, 2021
Thomas Knoblach Individual Corporate Director Jul 1, 2011
Michael a Blair Individual Corporate OfficerCfo Sep 30, 2019
W-2 Managing EmployeeCfo Sep 30, 2019
Jeffrey Gau Individual Corporate Director Jul 1, 2017
Renee S Frauendienst Individual Corporate DirectorBoard Member Jul 1, 2017
Jacob Lyons Individual Corporate Director Jul 1, 2024
Richard Wehseler Individual Corporate Director Apr 21, 2018
Bobbie Bertram Individual Corporate Director Jul 1, 2011
Kenneth D Holmen Individual Corporate Director Jan 1, 2015
Sherri Liebl Individual Corporate OfficerExecutive Director Sep 30, 2019
David Anfinson Individual Corporate Director Apr 21, 2018
Daniel Abdul Individual Corporate Director Jul 1, 2022
James Hebl Individual Corporate Director Jul 1, 2017
Carrie Henning-Smith Individual Corporate Director Jun 30, 2024
Centracare Health System Organization, St Cloud, MN Operational/Managerial Control Jul 3, 1995
Bryan Rolph Individual Corporate Director Jul 1, 2019

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Centracare - St Cloud Hospital Inpatient RehabilitationSaint Cloud, MN, CCN 24T036 Hospital Operational/Managerial Control Apr 20, 2015

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 604

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.

View all 604

Affiliated clinicians 974

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

View all 974

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1043269798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE NORTH",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-307-3676",
            "fax_number": "320-656-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE NORTH",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-307-3676",
            "fax_number": "320-656-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1564 County Road 134",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563030346",
            "country_code": "US",
            "telephone_number": "320-229-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. CLOUD HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "320-307-3676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "331506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418902",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883747300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.