NPIMap

Organization Active NPI

Warren Community Hospital, Inc.

Doing business as North Valley Health Center

  • Critical Access Hospital
  • Warren, MN
National Provider Identifier
1073516357
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
327602 Issued in MN
Legal business name
WARREN COMMUNITY HOSPITAL, INC.
Doing business as
North Valley Health Center
Practice address
300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone
(218) 745-4211
Fax
(218) 745-4215
NPI assigned
May 31, 2005
Last updated
Dec 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Authorized official

Name
Mr. Jon E Linnell
Title
Ceo
Phone
(218) 745-4211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 327602 MN
Critical Access Hospital 282NC0060X 327602 MN Primary

Addresses

Primary practice location

300 W Good Samaritan Dr
Warren, MN 56762-1412

Mailing address

300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone (218) 745-4211

Other identifiers 2

IdentifierTypeStateIssuer
93752500MedicaidMN
039845400MedicaidMN

Other names 1

  • North Valley Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccd@direct.northvalleyheatlh.org Direct

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040908000953 MN Part B Supplier - Clinic/Group Practice 2264408566 Receives reassigned benefits from 112 practitioners
1 other NPI on this enrollment
Practice locations: Warren, MN
O20110316000907 MN Part A Provider - Critical Access Hospital 2264408566 Receives reassigned benefits from 5 practitioners
Practice locations: Warren, MN
O20110316000942 MN Part A Provider - Critical Access Hospital 2264408566 Practice locations: Warren, MN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1073516357. Details of each certification follow.

Hospital certification: CCN 241337

Legal name
WARREN COMMUNITY HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 3, 2002
Last certification
Aug 21, 2024
Beds
12
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Enrollment address
300 W Good Samaritan Dr
Warren, MN 56762-1412
Main/Primary Hospital Location

Hospital certification: CCN 24Z337

Legal name
WARREN COMMUNITY HOSPITAL INC
Doing business as
NORTH VALLEY HEALTH CENTER
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1980 in MN
Enrollment address
300 W Good Samaritan Dr
Warren, MN 56762-1412
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
North Valley Health CenterCCN 241337 · All quality measures
Type
Critical Access 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

109 S Minnesota St
Ste 1
Warren, MN 56762
Phone (218) 745-3261

Interoperability endpoints

  • Direct secure messaging: ccd@direct.northvalleyheatlh.org

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Darlene Dvorak Individual Corporate Director Jun 1, 2022
Corporate Director Jun 1, 2023
Shari Swanson Individual Corporate DirectorBoard President Jun 1, 2017
Corporate Director Jun 1, 2017
Mitchell Kotrba Individual Corporate OfficerCfo May 18, 2010
W-2 Managing EmployeeCfo May 18, 2010
Operational/Managerial ControlCfo May 10, 2018
Corporate Director May 18, 2010
Operational/Managerial ControlCfo May 18, 2010
Warren Community Hospital Inc Organization, Warren, MN Non-profit Operational/Managerial Control Nov 20, 2013 100%
Operational/Managerial Control May 18, 2010
Jason Boman Individual Corporate Director Jun 1, 2013
Jon E Linnell Individual Corporate OfficerCeo Mar 1, 2016
W-2 Managing EmployeeCeo Mar 1, 2016
Operational/Managerial ControlCeo Mar 1, 2016
Corporate OfficerCeo Jan 1, 2016
W-2 Managing EmployeeCeo Jan 1, 2016
Operational/Managerial ControlCeo Jan 1, 2016
James Widner Individual Corporate Director Jun 1, 2013
Jeff Hanson Individual Corporate Director Jun 1, 2018
Mallory Craik Individual Corporate Director Jun 1, 2020
Mark Yutrzenka Individual Corporate Director Jun 1, 2022
Corporate Director Jun 1, 2023
Ron Leverington Individual Corporate Director Jun 1, 2016

Owners & managing parties with NPI records 1

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
North Valley Health Center ClinicWarren, MN, CCN 243409 Rural health clinic Operational/Managerial Control (100%) Aug 14, 1980

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 1

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

Practitioners & affiliated clinicians

Practitioners 113

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 113

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609372800000",
    "number": "1073516357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W GOOD SAMARITAN DR",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621412",
            "telephone_number": "218-745-4211",
            "fax_number": "218-745-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W GOOD SAMARITAN DR",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621412",
            "telephone_number": "218-745-4211",
            "fax_number": "218-745-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "LINNELL",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-745-4211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "327602",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "327602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93752500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039845400",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccd@direct.northvalleyheatlh.org",
            "affiliation": "N",
            "endpointDescription": "All providers at North Valley Health Center use this same endpoint",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 W Good Samaritan Dr",
            "city": "Warren",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567621412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "North Valley Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Valley Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MN

Sources for this page

Verify at the official NPI Registry.