Msocs-Kasson

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MSOCS-KASSON

Practice address

1101 1St Ave NE
Kasson, MN 55944-1604

Phone

(507) 634-4025

NPI assigned

Nov 17, 2006

Last updated

Jun 18, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

EASTERN MINNESOTA STATE OPERATED COMMUNITY SERVICESAs reported in NPPES

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

Authorized official

Name

Roger Deneen

Title

Residential Prog SVCS Director

Phone

(651) 582-1857

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Msocs-Bloomington

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1063585875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64979",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551640979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 1ST AVE NE",
            "city": "KASSON",
            "state": "MN",
            "postal_code": "559441604",
            "telephone_number": "507-634-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSOCS-KASSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN MINNESOTA STATE OPERATED COMMUNITY SERVICES",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "DENEEN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "RESIDENTIAL PROG SVCS DIRECTOR",
        "authorized_official_telephone_number": "651-582-1857"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "733845700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Mayer
• McBe Company (Weber & Judd - Kasson)
• Patrick Sean McDonough
• Meyer Chiropractic Center, CHTD.
• Lon L. Meyer, D.C.
• Dominic Anthony Noble-Henden, MS, LAT, ATC, CES
• David Michael Packer
• Ella Eileen Pitzenberger
• Nicole Marguerite Rothgarn, CNM
• David Sabotta

• Intellectual Disabilities Intermediate Care Facility in Kasson, MN
• Providers in Kasson, MN by specialty
• Intellectual Disabilities Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.