NPIMap

Organization Active NPI

Divine Providence Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Ivanhoe, MN
National Provider Identifier
1265467526
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
331042 Issued in MN
Legal business name
DIVINE PROVIDENCE HEALTH CENTER
Practice address
312 E George St
Ivanhoe, MN 56142-9707
Phone
(507) 694-1414
NPI assigned
Jul 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory A Wilson
Title
Ceo
Phone
(507) 694-1414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 331042 MN Primary

Addresses

Primary practice location

312 E George St
Ivanhoe, MN 56142-9707

Mailing address

312 E George St
PO Box 136
Ivanhoe, MN 56142-9707
Phone (507) 694-1414

National Provider Directory

National Provider Directory
Tax ID family
Divine Providence Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265467526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E GEORGE ST",
            "address_2": "PO BOX 136",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561429707",
            "telephone_number": "507-694-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E GEORGE ST",
            "city": "IVANHOE",
            "state": "MN",
            "postal_code": "561429707",
            "telephone_number": "507-694-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-694-1414"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MN",
            "license": "331042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ivanhoe, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.