NPIMap

Organization Active NPI

Saint Elizabeths Hospital of Wabasha Inc

Doing business as Gundersen St. Elizabeth's Hospital and Clinics

  • Clinic/Center
  • Wabasha, MN
National Provider Identifier
1073050274
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
Gundersen St. Elizabeth's Hospital and Clinics
Practice address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone
(651) 565-4531
Fax
(651) 565-2482
NPI assigned
Jan 25, 2017
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT ELIZABETHS HOSPITAL OF WABASHA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
John K Wolfe
Title
Cfo
Phone
(651) 565-5553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1200 Grant Blvd W
Wabasha, MN 55981-1042

Mailing address

1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-4531

Other names 1

  • Gundersen St. Elizabeth's Hospital and Clinics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000811 MN Part B Supplier - Clinic/Group Practice 5092619387 Receives reassigned benefits from 157 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wabasha, MN

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeths Hosp Wabasha5 organizations share this tax ID, including this one
Part of
St Elizabeths Hosp Wabasha

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1073050274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "enumeration_date": "2017-01-25",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-565-5553"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen St. Elizabeth's Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wabasha, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.