Active NPI
Morgan Memorial Foundation Inc
- Skilled Nursing Facility
- Morgan, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 327789
- Legal business name
- MORGAN MEMORIAL FOUNDATION INC
- Practice address
- 96 3Rd St E
Morgan, MN 56266-1414 - Phone
- (507) 249-3143
- Fax
- (507) 249-2310
- NPI assigned
- Oct 14, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James D Broich
- Title
- Administrator
- Phone
- (507) 249-3143
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 327789 | MN | Primary |
Addresses
Primary practice location
96 3Rd St E
Morgan, MN 56266-1414
Mailing address
96 3Rd St E
Morgan, MN 56266-1414
Phone (507) 249-3143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040122000650 | MN | Part A Provider - Skilled Nursing Facility | 0446152227 | Practice locations: Morgan, MN |
Skilled nursing facility certification: CCN 245594
- Legal name
- MORGAN MEMORIAL FOUNDATION INC
- Doing business as
- GIL-MOR MANOR AND GIL-MOR HAVEN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1991
- Last certification
- Jun 13, 2024
- Beds
- 35
- Ownership / control type
- Other Nonprofit
- Organization structure
- Other
- Incorporated
- Dec 30, 1959 in MN
- Enrollment address
- 96 3Rd St E
Morgan, MN 56266-1414 - Nursing home name
- GIL-MOR MANOR
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Gil-Mor Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Nov 1, 1991
- Medicare certification status
- Active
- Certified beds
- 35
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0651596 | Gil-Mor Manor | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
96 3rd St E
Morgan, MN 56266
Phone (507) 249-3115
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lynn M Madsen | Corporate Director | Mar 1, 2011 | |
| Tammy Meyers | Corporate Director | Nov 1, 2011 | |
| Lynn M Pietig | Corporate Director | Nov 1, 2003 | |
| David I Simonsen | Corporate Director | Nov 1, 2008 | |
| Douglas Kopischke | Corporate Director | Nov 1, 2005 | |
| Terrie E Rothmeier | W-2 Managing Employee | Jul 16, 2016 | |
| Operational/Managerial Control | Jul 16, 2016 | ||
| Suzanne Miller | W-2 Managing Employee | Sep 3, 2014 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Sleepy Eye, MN
- NPI 1083810907
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1241395200000",
"number": "1104815984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 3RD ST E",
"city": "MORGAN",
"state": "MN",
"postal_code": "562661414",
"telephone_number": "507-249-3143",
"fax_number": "507-249-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 3RD ST E",
"city": "MORGAN",
"state": "MN",
"postal_code": "562661414",
"telephone_number": "507-249-3143",
"fax_number": "507-249-2310"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MORGAN MEMORIAL FOUNDATION INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-14",
"last_updated": "2009-05-04",
"status": "A",
"authorized_official_last_name": "BROICH",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "507-249-3143"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MN",
"license": "327789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Morgan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.