NPIMap

Organization Active NPI

Fairview Health Services

Doing business as Fairview Lakes Hospital

  • General Acute Care Hospital
  • Wyoming, MN
National Provider Identifier
1083692941
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
342932 Issued in MN
Legal business name
FAIRVIEW HEALTH SERVICES
Doing business as
Fairview Lakes Hospital
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7000
Fax
(651) 982-7110
NPI assigned
Jan 2, 2006
Last updated
Jun 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Authorized official

Name
Maureen Veronica-Reger Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X NU
Hospitalist Physician 208M00000X NU
General Acute Care Hospital 282N00000X 342932 MN Primary
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other identifiers 14

IdentifierTypeStateIssuer
27581OtherMNHEALTHPARTNERS
468S0FAOtherMNBCBS
5025460OtherMNMEDICA
110294OtherMNHEALTHPARTNERS
124637OtherMNUCARE
140045OtherMNUCARE
19718OtherMNPREFERREDONE
4986OtherMNPREFERREDONE
792825400MedicaidMN
2116219OtherMNMEDICA
300982OtherMNUCARE
429880OtherMNMEDICA
9801057OtherMNMEDICA
1640HDIOtherMNBCBS

Other names 2

  • Fairview Lakes Hospital Doing business as
  • M Health Fairview Lakes Medical Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000461 MN Part B Supplier - Clinic/Group Practice 1951213057 Receives reassigned benefits from 4,101 practitioners
This NPI is an additional NPI on the enrollment
O20051010000419 MN Part A Provider - Hospital 1951213057 2 other NPIs on this enrollment
Practice locations: Chisago City, MN; Wyoming, MN; Rush City, MN; Pine City, MN; North Branch, MN; Lino Lakes, MN; Hugo, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083692941. Details of each certification follow.

Hospital certification: CCN 240050B

Legal name
FAIRVIEW HEALTH SERVICES
Doing business as
FAIRVIEW LAKES HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 20, 1972 in MN
Enrollment address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Fairview Hand Center69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Melissa Ann Geller Individual Corporate DirectorDirector Jan 1, 2022
David Martin Levy Individual Corporate DirectorDirector Jan 1, 2022
Maureen Veronica-Reger Ring Individual Corporate DirectorAo Director Dec 1, 2022
W-2 Managing EmployeeAo Director Dec 1, 2022
Stephen Jeffrey Swensen Individual Corporate DirectorDirector Jan 1, 2022
Srijoy Mahapatra Individual Corporate DirectorBoard of Director Oct 1, 2024
Jodi Richard Individual Corporate DirectorDirector Jan 1, 2019
Shawntera Monique Hardy Individual Corporate DirectorDirector Jan 1, 2022
Joe Charles Gaylord Individual Corporate DirectorEvp Cfo Sep 1, 2022
Kenneth Joseph Roering Individual Corporate DirectorBoard of Director Feb 23, 2017
James Hereford Individual Corporate DirectorPresident Dec 10, 2016
Paul Jr Hill Individual Corporate DirectorDirector Jan 1, 2022
Tami Lynn Reller Individual Corporate DirectorBoard of Director May 9, 2024
Michael Roger Connly Individual Corporate DirectorDirector Jun 1, 2017
Karen Swearingen Richard Individual Corporate DirectorBoard of Director Jan 1, 2025
John Charles Heinmiller Individual Corporate DirectorDirector Jul 1, 2017
Julie S Causey Individual Corporate DirectorDirector Jun 1, 2017
Barclay Edward Berdan Individual Corporate DirectorDirector Jan 1, 2022
Timothy Engel Marx Individual Corporate DirectorDirector Jun 1, 2017

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 4

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

FacilityTypeRoleSince
Capitol Park Mental Health HospitalSaint Paul, MN, CCN 244019 Hospital 5% Or Greater Direct Ownership Interest (12.1%) Dec 7, 2021
Accentcare Fairview Home Health - East, LLCOakdale, MN, CCN 247166 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Home Health - West, LLCSaint Paul, MN, CCN 247078 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Hospice - West, LLCSaint Paul, MN, CCN 241514 Hospice 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782432000000",
    "number": "1083692941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7000",
            "fax_number": "651-982-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-02",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "VERONICA-REGER",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "342932",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "27581",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "468S0FA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5025460",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "110294",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "124637",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140045",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "19718",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "4986",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "792825400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2116219",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "300982",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "429880",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "9801057",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1640HDI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Lakes Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Fairview Lakes Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "M Health Fairview Lakes Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.