NPIMap

Organization Active NPI

Coteau Des Prairies Hospital

Doing business as CDP Health Care System-Browns Valley Clinic

  • Clinic/Center
  • Browns Valley, MN
National Provider Identifier
1255477162
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
60020 Issued in SD
Legal business name
COTEAU DES PRAIRIES HOSPITAL
Doing business as
CDP Health Care System-Browns Valley Clinic
Practice address
404 West Broadway
Browns Valley, MN 56219
Phone
(320) 695-2526
Fax
(320) 695-2106
NPI assigned
Jan 29, 2007
Last updated
Aug 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COTEAU DES PRAIRIES HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

Name
Craig Kantos
Title
Ceo
Phone
(605) 698-4601

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 60020 SD Primary
Rural Health Clinic/Center 261QR1300X 60020 SD

Addresses

Primary practice location

404 West Broadway
Browns Valley, MN 56219

Mailing address

205 Orchard Dr
Sisseton, SD 57262-2398
Phone (605) 698-7681

Other identifiers 4

IdentifierTypeStateIssuer
03070116200OtherPRIMEWEST
5160MedicaidND
05160MedicaidND
49082COOtherMNBLUE CROSS

Other names 1

  • CDP Health Care System-Browns Valley Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080401000657 MN Part B Supplier - Clinic/Group Practice 8022926468 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Herman, MN
O20151204001700 MN Part A Provider - Rural Health Clinic 8022926468 Practice locations: Browns Valley, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255477162. Details of each certification follow.

Rural health clinic certification: CCN 243477

Legal name
COTEAU DES PRAIRIES HOSPITAL
Doing business as
COTEAU DES PRAIRIES HEALTH CARE SYSTEM-BROWNS VALLEY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 9, 2016
Last certification
Jun 9, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 1995 in SD
Enrollment address
404 W Broadway
Browns Valley, MN 56219-7026
Related CCNs
241339

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Coteau Des Prairies Hospital Inc7 organizations share this tax ID, including this one
Part of
Coteau Des Prairies Hospital Inc

Other organizations with this tax ID 6

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Faye L Johnston Individual Corporate DirectorBoard of Directors Member Jul 1, 2009
Matthew R Glynn Individual Corporate DirectorBoard of Directors Member May 1, 2015
Terry H. Jaspers Individual Corporate DirectorBoard of Directors Member Dec 1, 1990
Janet Frederick Individual W-2 Managing EmployeeBusiness Office Manager Aug 29, 2021
Julie Wolf Individual W-2 Managing EmployeeCredentialing Specialist Mar 27, 2022
Steven D McCleerey Individual Corporate DirectorBoard of Directors Member Apr 1, 2008
Tanelle Steichen Individual W-2 Managing EmployeeClinic Office Coordinator Mar 2, 2001
April Hieb Individual W-2 Managing EmployeeChief Nursing Officer Nov 1, 2019
Lyle Gene Bien Individual Corporate DirectorBoard of Directors Member Nov 1, 2019
Patrick Dady Individual Corporate DirectorBoard of Directors Member Nov 15, 2018
Yvonne a Hippen Individual Corporate DirectorBoard of Directors Member Feb 18, 2014
Craig a Kantos Individual Corporate OfficerChief Executive Officer Nov 15, 2018
Coteau Des Prairies Hospital Organization, Sisseton, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 1995 100%
Operational/Managerial Control Jun 1, 1995 100%
David G Gleason Individual Corporate DirectorBoard of Directors Member Oct 1, 2014
Erin C Cameron Individual Corporate DirectorBoard of Directors Member Jul 1, 2009
Michaela Johnson Individual W-2 Managing EmployeeClinic Director Jan 4, 2022

Owners & managing parties with NPI records 5

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

  • Coteau Des Prairies Hospital

    dba Coteau des Prairies Health Care System

    • Home Health Agency
    • Sisseton, SD
    • NPI 1003825738

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Coteau Des Prairies Hospital

    dba Coteau des Prairies Health Care System

    • Medicare Defined Swing Bed Hospital Unit
    • Sisseton, SD
    • NPI 1265502686

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Coteau Des Prairies Hospital

    dba Coteau des Prairies Health Care System

    • Critical Access Hospital
    • Sisseton, SD
    • NPI 1417051517

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Coteau Des Prairies Hospital

    dba Coteau des Prairies Health Care System - Rosholt Clinic

    • Clinic/Center
    • Rosholt, SD
    • NPI 1588978589

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Coteau Des Prairies Hospital

    dba Coteau des Prairies Health Care System

    • Rural Health Clinic/Center
    • Sisseton, SD
    • NPI 1881740629

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Coteau Des Prairies Health Care SystemSisseton, SD, CCN 431339 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2003
Coteau Des Prairies Health Care SystemSisseton, SD, CCN 43Z339 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2003
Tekakwitha Living CenterSisseton, SD, CCN 435038 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2016
Jan 1, 2016
Coteau Des Prairies Health Care SystemSisseton, SD, CCN 437067 Home health agency 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2022
Coteau Des Prairies Health Care SystemSisseton, SD, CCN 433420 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2002
Coteau Des Prairies Health Care System-Rosholt ClinicRosholt, SD, CCN 433446 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2010
Aug 1, 2010

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1255477162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ORCHARD DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572622398",
            "telephone_number": "605-698-7681",
            "fax_number": "605-698-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WEST BROADWAY",
            "city": "BROWNS VALLEY",
            "state": "MN",
            "postal_code": "56219",
            "telephone_number": "320-695-2526",
            "fax_number": "320-695-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTEAU DES PRAIRIES HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COTEAU DES PRAIRIES HOSPITAL",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "KANTOS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-698-4601"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SD",
            "license": "60020",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SD",
            "license": "60020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "03070116200",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5160",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05160",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "49082CO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDP Health Care System-Browns Valley Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CDP Health Care System-Browns Valley Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Browns Valley, MN

Sources for this page

Verify at the official NPI Registry.