Allina Health System

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

365723 Issued in MN

Legal business name

ALLINA HEALTH SYSTEM

Doing business as

Allina Health Faribault Medical Center

Practice address

200 State Ave
Faribault, MN 55021-6339

Phone

(507) 334-6451

NPI assigned

Apr 24, 2014

Last updated

Aug 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Whitney Johnson

Title

Hospital President

Phone

(651) 216-0968

Specialties & licenses 1

Addresses

Other names 1

• Allina Health Faribault Medical Center Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154741577. Details of each certification follow.

• CCN 240071 Hospital · Active · Details

Hospital certification: CCN 240071

Legal name

ALLINA HEALTH SYSTEM

Doing business as

ALLINA HEALTH FARIBAULT MEDICAL CENTER

Certification status

Active

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Sep 12, 2015

Beds

99

Ownership / control type

Private (not for profit)

Most recent change of ownership

Jan 1, 2015 (3 total)

Organization structure

CorporationNon-profit

Incorporated

Sep 28, 1983 in MN

Enrollment address

200 State Ave
Faribault, MN 55021-6339
Main/Primary Hospital Location

Hospital subgroups

Acute care

Other NPIs on the same Medicare enrollment 1

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

• Allina Health System

  dba Allina Health Faribault Medical Center Professional Services

  • Emergency Medicine Physician
  • Faribault, MN
  • NPI 1063832475

  O20141013002446

  Same enrollment

Listed as

Allina Health Faribault Medical CenterCCN 240071 · All quality measures

Overall star rating

3 of 5

Type

Acute Care Hospitals

Ownership

Voluntary non-profit - Private

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

Yes

All disclosed owners & managing parties 28

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

Owners & managing parties with NPI records 1

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

• Daniel Thomas O'Laughlin, M.D.

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1851334825

  Corporate Director

  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.

Practitioners 15

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.

• Justin C Boeke, M.D.

  • Obstetrics & Gynecology Physician
  • Woodbury, MN
  • NPI 1073933321
  NPD (past)
• Bukhari Mohamed Ali Burale, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1598255317
  NPD (past)
• Raquel Cardenas-Stophel, DO

  • Obstetrics & Gynecology Physician
  • Faribault, MN
  • NPI 1376045112
  NPD (past)
• Austin Cudak

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1104485457
  NPD (past)
• Isabelle Jennifer Rose Farro Del Castillo, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1134688955
  NPD (past)
• Kris W Drevlow, DO

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1720049042
  NPD (past)
• Amy J Elliott, M.D.

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1841281904
  NPD (past)
• Brandi Hope Gorden Klukas, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1568026342
  NPD (past)
• Rachel K Harlos, MD

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1497285720
  NPD (past)
• Eric Goddard Heegaard, MD

  • Obstetrics & Gynecology Physician
  • Minneapolis, MN
  • NPI 1407852197
  NPD (past)
• Charles Louis Hirt Jr., MD

  • Obstetrics & Gynecology Physician
  • Minneapolis, MN
  • NPI 1285605006
  NPD (past)
• Rose Marie Spencer Leslie, MD

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1861980583
  NPD (past)

Affiliated clinicians 281

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

• Raed H Abdelhadi, MD

  • Clinical Cardiac Electrophysiology Physician
  • Minneapolis, MN
  • NPI 1518057413

  Hospital

  Care Compare affiliation
• Casandra Lynn Ahle

  • Certified Registered Nurse Anesthetist
  • Rochester, MN
  • NPI 1023580453

  Hospital

  Care Compare affiliation
• Aqeel Ahmad, M.D.

  • Nephrology Physician
  • Saint Paul, MN
  • NPI 1497942866

  Hospital

  Care Compare affiliation
• Carissa L. Allen, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • St Louis Park, MN
  • NPI 1447554027

  Hospital

  Care Compare affiliation
• Eric Patrick Anderson, M.D.

  • Surgery Physician
  • Minneapolis, MN
  • NPI 1962729327

  Hospital

  Care Compare affiliation
• Peter N Anyona, CRNA

  • Certified Registered Nurse Anesthetist
  • Rochester, MN
  • NPI 1245030576

  Hospital

  Care Compare affiliation
• Stephanie M Arendt, CNP

  • Nurse Practitioner
  • Faribault, MN
  • NPI 1427364322

  Hospital

  Care Compare affiliation
• Mysoon Ayuob

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1003251885

  Hospital

  Care Compare affiliation
• Joshua Anthony Bailey, M.D.

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1053843581

  Hospital

  Care Compare affiliation
• Stefanie Marie Barnes, PA-C

  • Physician Assistant
  • Apple Valley, MN
  • NPI 1174181838

  Hospital

  Care Compare affiliation
• Gayle Bauer, NP-C

  • Nurse Practitioner
  • Golden Valley, MN
  • NPI 1407363583

  Hospital

  Care Compare affiliation
• Jonathan David Bauman, MD

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1841829868

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1154741577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MAIL ROUTE 10585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216339",
            "telephone_number": "507-334-6451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 State Ave",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550216368",
            "country_code": "US",
            "telephone_number": "507-497-3790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLINA HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "HOSPITAL PRESIDENT",
        "authorized_official_telephone_number": "651-216-0968"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "365723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allina Health Faribault Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zahara Ali
• Allied Health Group LLC
• Allina Health System (Allina Health Faribault Clinic)
• Allina Health System (Allina Health Cancer Institute - Faribault)
• Allina Health System (Allina Health Faribault Medical Center Professional Services)
• Allina Health System (Allina Health Urgent Care Faribault)
• Allina Health System (Courage Kenny Rehabilitation Associates)
• Allina Health System (Allina Health Faribault Pharmacy)
• Allina Health System (Allina Health Faribault Pharmacy)
• Allina Health System (Allina Health Orthopedic, Podiatry and Spine Clinic-Faribault)

• General Acute Care Hospital in Faribault, MN
• Providers in Faribault, MN by specialty
• General Acute Care Hospital in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.

Verify at the official NPI Registry.