NPIMap

Organization Active NPI

Ridgeview Medical Center

  • Home Health Agency
  • Waconia, MN
National Provider Identifier
1104954445
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
334660 Issued in MN
Legal business name
RIDGEVIEW MEDICAL CENTER
Practice address
501 South Maple St
Suite 1
Waconia, MN 55387-0096
Phone
(952) 442-6030
Fax
(952) 442-6542
NPI assigned
Feb 28, 2007
Organization subpart
Yes
Parent organization
RIDGEVIEW MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Authorized official

Name
Michael J Phelps
Title
President/Ceo
Phone
(952) 442-2191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 334660 MN Primary

Addresses

Primary practice location

501 South Maple St
Suite 1
Waconia, MN 55387-0096

Mailing address

501 South Maple St
Suite 1
Waconia, MN 55387-0096
Phone (952) 442-6030

Other identifiers 1

IdentifierTypeStateIssuer
783590600MedicaidMN

Other names 1

  • Ridgeview Home Care Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000267 MN Part A Provider - Home Health Agency 9234041997 Practice locations: Waconia, MN

Home health agency certification: CCN 247168

Legal name
RIDGEVIEW MEDICAL CENTER
Doing business as
RIDGEVIEW HOME CARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 29, 1984
Last certification
May 2, 2018
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Enrollment address
501 S Maple St
Ste 1
Waconia, MN 55387-0096

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ridgeview Home Care ServicesCCN 247168
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Jun 29, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D1105221Ridgeview Home Health Services/HME Care501 South Maple Street - Suite 1, Waconia, MN 55387Certificate of waiverFeb 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ridgeview Home Care2 organizations share this tax ID, including this one
Part of
Ridgeview Medical Center

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Theresa J Dalen Individual Corporate DirectorBoard of Director Feb 1, 2015
Heather Reighard Individual Corporate OfficerBoard Member Jan 1, 2023
Brian S Mark Individual Corporate DirectorBoard of Director Feb 1, 2015
Michael Schuler Individual Corporate OfficerBoard Member Jan 1, 2023
Elaine M Arion Individual Corporate DirectorVP Patient Care and Cno Jan 1, 2018
Operational/Managerial ControlVP Patient Care and Cno Jan 1, 2018
Christopher Bielke Individual W-2 Managing EmployeeManager of Payer Strategy Jun 20, 2022
Julie a Osterberg Individual Corporate DirectorBoard of Director Feb 1, 2018
David Kirsch Individual Corporate OfficerBoard Member Jan 1, 2023
Michael J Phelps Individual Corporate OfficerChief Executive Officer Jun 24, 2016
Operational/Managerial Control Jan 1, 2012
Jeffrey T Nelson Individual Corporate DirectorBoard of Director Feb 1, 2010
Brent K Wordelman Individual Corporate OfficerChief Financial Officer Apr 20, 2026
Van Colson Individual Corporate OfficerBoard Member Jan 1, 2023
Stuart Groninga Individual Corporate OfficerBoard Member Jan 1, 2023
Aaron a Bloomquist Individual Corporate OfficerChief Financial Officer Jan 1, 2022

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Minnesota Valley Health Center IncLe Sueur, MN, CCN 241375 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2016
Minnesota Valley Health Center IncLe Sueur, MN, CCN 24Z375 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 24, 2016
Ridgeview Sibley Medical CenterArlington, MN, CCN 24Z311 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Sibley Medical CenterArlington, MN, CCN 241311 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Winthrop ClinicWinthrop, MN, CCN 243430 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Gaylord ClinicGaylord, MN, CCN 243429 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Ridgeview Arlington ClinicArlington, MN, CCN 243428 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 7

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

Practitioners & affiliated clinicians

Practitioners 407

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 407

Affiliated clinicians 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1104954445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SOUTH MAPLE ST",
            "address_2": "SUITE 1",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553870096",
            "telephone_number": "952-442-6030",
            "fax_number": "952-442-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SOUTH MAPLE ST",
            "address_2": "SUITE 1",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553870096",
            "telephone_number": "952-442-6030",
            "fax_number": "952-442-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEVIEW MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIDGEVIEW MEDICAL CENTER",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "952-442-2191"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "334660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "783590600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgeview Home Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.