Good Shepherd Lutheran Home of Sauk Rapids Minnesota

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

333736 Issued in MN

Legal business name

GOOD SHEPHERD LUTHERAN HOME OF SAUK RAPIDS MINNESOTA

Practice address

1115 4TH Ave N
Sauk Rapids, MN 56379-2201

Phone

(320) 252-6525

Fax

(320) 259-3463

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Allen Glanzer

Title

Administrator Ceo

Phone

(320) 252-6525

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Good Shepherd Home Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 247230

Legal name

GOOD SHEPHERD LUTHERAN HOME OF SAUK RAPIDS MINNESOTA

Doing business as

GOOD SHEPHERD HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 23, 1987

Last certification

Jul 22, 2021

Ownership / control type

Non-Profit

Organization structure

CorporationNon-profit

Incorporated

Nov 1, 1963 in MN

Enrollment address

1115 4TH Ave N
Sauk Rapids, MN 56379-2201

Other NPIs with the same Medicare PAC ID 1

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

• Good Shepherd Lutheran Home of Sauk Rapids, Minnesota

  • Skilled Nursing Facility
  • Sauk Rapids, MN
  • NPI 1952332975

  3173422797

  Same PAC ID

Listed as

Good Shepherd Home Health CareCCN 247230

Overall star rating

2.5 of 5

Ownership

Non-Profit

Certified

Jan 23, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Tax ID family

Good Shepherd Cottages7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

• Good Shepherd Homes, Inc.

  • Assisted Living Facility
  • Sauk Rapids, MN
  • NPI 1336316611
  NPD tax ID
• Good Shepherd Lutheran Home of Sauk Rapids, Minnesota

  • Skilled Nursing Facility
  • Sauk Rapids, MN
  • NPI 1952332975
  NPD tax ID
• Good Shepherd Lutheran Home of Sauk Rapids, MN, Inc.

  • Alzheimer Center (Dementia Center)
  • Sauk Rapids, MN
  • NPI 1396807962
  NPD tax ID
• Shepherd Court Apartments

  • Assisted Living Facility
  • Sauk Rapids, MN
  • NPI 1518134899
  NPD tax ID
• Shepherd Oak Apartments, Inc.

  • Assisted Living Facility
  • Sauk Rapids, MN
  • NPI 1316114606
  NPD tax ID
• Shepherd Oak West Apartments Inc

  • Assisted Living Facility
  • Sauk Rapids, MN
  • NPI 1720255995
  NPD tax ID

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.

Affiliated clinicians 1

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

• Tamara Lois Rakke, AGPCNP

  • Adult Health Nurse Practitioner
  • Stillwater, MN
  • NPI 1932655420

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1245306737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 4TH AVE N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792201",
            "telephone_number": "320-252-6525",
            "fax_number": "320-259-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 4TH AVE N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792201",
            "telephone_number": "320-252-6525",
            "fax_number": "320-259-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD LUTHERAN HOME OF SAUK RAPIDS MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "GLANZER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR CEO",
        "authorized_official_telephone_number": "320-252-6525",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "333736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168023400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Judith Finnegan-Baker, RPH,
• Cheri Gunderson Gieski, LMFT
• Benjamin Glasser
• Lacie Jayne Glasser, LPCC
• Good Shepherd Homes, Inc.
• Good Shepherd Lutheran Home of Sauk Rapids, Minnesota
• Good Shepherd Lutheran Home of Sauk Rapids, MN, Inc.
• Stacey M Gorman, P.T.
• Granite Care Home, Inc.
• Guardian Pharmacy of Minnesota LLC

• Home Health Agency in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.