Coteau Des Prairies Hospital
Organization Active NPI Clinic/Center · Browns Valley, MN
NPI 1255477162 · NPPES record last updated Aug 8, 2024
Key facts
- NPI
- 1255477162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 60020 (SD)
- Legal business name
- COTEAU DES PRAIRIES HOSPITAL
- Practice address
- 404 West Broadway
Browns Valley, MN 56219 - Phone
- (320) 695-2526
- Fax
- (320) 695-2106
- NPI assigned
- Jan 29, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- COTEAU DES PRAIRIES HOSPITAL
Authorized official
- Name
- Craig Kantos
- Title
- Ceo
- Phone
- (605) 698-4601
Owners & managing parties with NPI records 5
Owned or controlled facilities with NPI records 6
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 6
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 6
Practitioners 19
-
Angela Kay Gaikowski, NP-C
-
Mariah Eastman, PA
-
Jennifer M Hanson, RN, NP
-
Amy Camille Holsing, APRN CNP
-
Tracy Huntington, CRNA
-
Michael Paul Lowe, M.D.
-
Jennifer Steiner, CFNP
-
Judy C Beumer, MD
-
Terry Lee Larsen, D.O.
-
Alex Lunneborg, PA-C
-
Sarah Ann Trombetta, CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
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
- Corporation · Non-profit
- Incorporated
- Feb 21, 1995 in SD
- Enrollment address
- 404 W Broadway
Browns Valley, MN 56219-7026 - Related CCNs
- 241339
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Faye L Johnston |
Corporate Director |
Jul 1, 2009 | |
| Matthew R Glynn |
Corporate Director |
May 1, 2015 | |
| Terry H. Jaspers |
Corporate Director |
Dec 1, 1990 | |
| Janet Frederick |
W-2 Managing Employee |
Aug 29, 2021 | |
| Julie Wolf |
W-2 Managing Employee |
Mar 27, 2022 | |
| Steven D McCleerey |
Corporate Director |
Apr 1, 2008 | |
| Tanelle Steichen |
W-2 Managing Employee |
Mar 2, 2001 | |
| April Hieb |
W-2 Managing Employee |
Nov 1, 2019 | |
| Lyle Gene Bien |
Corporate Director |
Nov 1, 2019 | |
| Patrick Dady |
Corporate Director |
Nov 15, 2018 | |
| Yvonne a Hippen |
Corporate Director |
Feb 18, 2014 | |
| Craig a Kantos |
Corporate Officer |
Nov 15, 2018 | |
| Coteau Des Prairies Hospital |
5% Or Greater Direct Ownership Interest | Jun 1, 1995 | 100% |
| Operational/Managerial Control | Jun 1, 1995 | 100% | |
| David G Gleason |
Corporate Director |
Oct 1, 2014 | |
| Erin C Cameron |
Corporate Director |
Jul 1, 2009 | |
| Michaela Johnson |
W-2 Managing Employee |
Jan 4, 2022 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Coteau Des Prairies Health Care System |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2003 |
| Coteau Des Prairies Health Care System |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Apr 1, 2003 |
| Tekakwitha Living Center |
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 System |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2022 |
| Coteau Des Prairies Health Care System |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Dec 1, 2002 |
| Coteau Des Prairies Health Care System-Rosholt Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 2010 Aug 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Coteau Des Prairies Hos
- Part of
- Coteau Des Prairies Hos
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 60020 | SD | Yes |
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03070116200 | Other | PRIMEWEST | |
| 49082CO | Other | MN | BLUE CROSS |
| 05160 | Medicaid | ND | |
| 5160 | Medicaid | ND |
Other names
- CDP Health Care System-Browns Valley Clinic
Other providers in Browns Valley, MN
- Browns Valley Health Center, Inc.
- City of Browns Valley
- Michelle A Cooley
- Fergus Falls Medical Group, P.a.
- Liebe Drug Inc
- Ellen Marie Nigg-Johnson
- Traverse County Ind School Dist 801
All providers in Browns Valley, MN · Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.