NPIMap

Organization Active NPI

County of Meeker

Doing business as Meeker Memorial Hospital & Clinics - East/West

  • Rural Health Clinic/Center
  • Litchfield, MN
National Provider Identifier
1083221816
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COUNTY OF MEEKER
Doing business as
Meeker Memorial Hospital & Clinics - East/West
Practice address
612 S Sibley Ave
Litchfield, MN 55355-3340
Phone
(320) 693-4500
NPI assigned
Sep 25, 2020
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF MEEKERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Nicole Siegner
Title
Cfo
Phone
(320) 693-4512

Specialties & licenses 1

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

Addresses

Primary practice location

612 S Sibley Ave
Litchfield, MN 55355-3340

Mailing address

612 S Sibley Ave
Litchfield, MN 55355-3340
Phone (320) 693-4500

Other names 1

  • Meeker Memorial Hospital & Clinics - East/West Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040216000811 MN Part B Supplier - Clinic/Group Practice 0840109740 Receives reassigned benefits from 153 practitioners
6 other NPIs on this enrollment
Practice locations: Dassel, MN; Litchfield, MN
O20080429000879 MN Part A Provider - Critical Access Hospital 0840109740 Receives reassigned benefits from 102 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Litchfield, MN
O20200921001440 MN Part A Provider - Rural Health Clinic 0840109740 Practice locations: Litchfield, MN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1083221816. Details of each certification follow.

Hospital certification: CCN 241366

Legal name
COUNTY OF MEEKER
Doing business as
MEEKER MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2005
Last certification
Feb 1, 2018
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1952 in MN
Enrollment address
612 S Sibley Ave
Litchfield, MN 55355-3340
Other Hospital Practice Location

Rural health clinic certification: CCN 243491

Legal name
COUNTY OF MEEKER
Doing business as
MEEKER MEMORIAL HOSPITAL AND CLINICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 10, 2020
Last certification
Nov 10, 2020
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
612 S Sibley Ave
Litchfield, MN 55355-3340
Related CCNs
241366

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Meeker Memorial HospitalCCN 241366 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
County of Meeker

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
County of Meeker Organization, Litchfield, MN 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Operational/Managerial Control Jan 1, 1966 100%
Tyler Ulseth Individual Corporate OfficerCfo Sep 30, 2024
W-2 Managing EmployeeCfo Sep 30, 2024
Mary Ellen Wells Individual Contracted Managing EmployeeCeo Sep 30, 2024
Corporate OfficerCeo Sep 30, 2024
Contracted Managing Employee Sep 30, 2024
Jayne Holmgren Individual Operational/Managerial ControlClinic Manager Feb 1, 2020

Owners & managing parties with NPI records 3

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

  • County of Meeker

    dba Meeker Memorial Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Litchfield, MN
    • NPI 1578718482

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Meeker

    dba Meeker Memorial Hospital

    • Critical Access Hospital
    • Litchfield, MN
    • NPI 1598860215

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • County of Meeker

    dba Meeker Memorial Hospital & Clinics

    • Rural Health Clinic/Center
    • Dassel, MN
    • NPI 1952555146

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Meeker Memorial HospitalLitchfield, MN, CCN 24Z366 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Meeker Memorial HospitalLitchfield, MN, CCN 241366 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Meeker Memorial Hospital and ClinicsDassel, MN, CCN 243490 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1966
Jan 1, 1966

Owned or controlled facilities with NPI records 3

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

  • County of Meeker

    dba Meeker Memorial Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Litchfield, MN
    • NPI 1578718482

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Meeker

    dba Meeker Memorial Hospital

    • Critical Access Hospital
    • Litchfield, MN
    • NPI 1598860215

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Meeker

    dba Meeker Memorial Hospital & Clinics

    • Rural Health Clinic/Center
    • Dassel, MN
    • NPI 1952555146

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 155

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 155

Affiliated clinicians 138

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

View all 138

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1083221816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553340",
            "telephone_number": "320-693-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553340",
            "telephone_number": "320-693-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MEEKER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MEEKER",
        "enumeration_date": "2020-09-25",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "SIEGNER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-693-4512"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meeker Memorial Hospital & Clinics - East/West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Litchfield, MN

Sources for this page

Verify at the official NPI Registry.