Minnesota Neurorehabilitaion Hospital

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

Legal business name

MINNESOTA NEUROREHABILITAION HOSPITAL

Practice address

11615 State Ave
Brainerd, MN 56401-7306

Phone

(218) 828-2718

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Doug V. Seiler

Title

Special Populations Administrator

Phone

(218) 739-7224

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 243025

Legal name

MINNESOTA NEUROREHABILITATION HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Jun 30, 2010

Provider type (POS)

Hospital – Rehabilitation

Participating since

Feb 14, 1995

Last certification

Feb 2, 1995

Beds

16

Ownership / control type

State

Facility address

11615 State Avenue
Brainerd, MN 56401

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• State of Minnesota-Minnesota Management and Budget

  dba Minnesota State Veterans Homes

  • Skilled Nursing Facility
  • Luverne, MN
  • NPI 1568735090

  Member Of

  NPD member

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1205929981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64979",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551640979",
            "telephone_number": "651-431-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11615 STATE AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017306",
            "telephone_number": "218-828-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA NEUROREHABILITAION HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "SEILER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "SPECIAL POPULATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "218-739-7224",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009516800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Miller
• Joel S. Miller, D.D.S.
• Pamela Miller, OTR
• Mary Darlene Millicent, LICSW
• Paul Milloy
• Minnesota Specialty Health Systems-Brainerd
• Minnesota State Colleges and Universities (Central Lakes College)
• Minnesota Teen Challenge, Inc
• Minnesota Teen Challnge, Inc. (Minnesota Adult and Teen Challenge- Life renewal)
• Mjheldt Inc (Jefferson Hearing Aid Center)

• Rehabilitation Hospital in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Rehabilitation Hospital in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.