Organization Active NPI

Parkview Manor Nursing Home

  • Skilled Nursing Facility
  • Ellsworth, MN
National Provider Identifier
1306840368
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
327175 Issued in MN
Legal business name
PARKVIEW MANOR NURSING HOME
Practice address
308 W Sherman Ave
Ellsworth, MN 56129-1016
Phone
(507) 967-2482
Fax
(507) 967-2141
NPI assigned
Jun 8, 2005
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
Mr. Michael J Werner
Title
Administrator
Phone
(507) 967-2482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 327175 MN Primary

Addresses

Primary practice location

308 W Sherman Ave
Ellsworth, MN 56129-1016

Mailing address

308 Sherman Avenue
Ellsworth, MN 56129-1016
Phone (507) 967-2482

Other identifiers 1

IdentifierTypeStateIssuer
104740000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120426000397 MN Part A Provider - Skilled Nursing Facility 1951563535 Practice locations: Ellsworth, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306840368. Details of each certification follow.

Skilled nursing facility certification: CCN 245553

Legal name
PARKVIEW MANOR NURSING HOME
Doing business as
PARKVIEW MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1991
Last certification
Mar 27, 2025
Beds
37
Ownership / control type
City
Organization structure
OtherNon-profit
Incorporated
in MN
Enrollment address
308 W Sherman Ave
Ellsworth, MN 56129-1016
Nursing home name
PARKVIEW MANOR NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Parkview Manor Nursing HomeCCN 245553 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Government - City
Certified
Mar 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3730.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0901545Parkview Manor Nursing Home308 Sherman Avenue, Ellsworth, MN 56129Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
City of Ellsworth Organization, Ellsworth, MN Created for acquisition 5% Or Greater Direct Ownership Interest Oct 1, 1970 100%
Parkview Manor Nursing Home Organization, Ellsworth, MN Non-profit Other Oct 1, 1970 100%
Colette Smythe Individual Corporate OfficerChair of Parkview Manor Board Mar 1, 2008
Dennis James Dejager Individual W-2 Managing EmployeeAd; Apr 8, 2024
Adp of the SNF Nov 18, 2024

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306840368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 SHERMAN AVENUE",
            "city": "ELLSWORTH",
            "state": "MN",
            "postal_code": "561291016",
            "telephone_number": "507-967-2482",
            "fax_number": "507-967-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W SHERMAN AVE",
            "city": "ELLSWORTH",
            "state": "MN",
            "postal_code": "561291016",
            "telephone_number": "507-967-2482",
            "fax_number": "507-967-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKVIEW MANOR NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-967-2482",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "327175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104740000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, MN

Sources for this page

Verify at the official NPI Registry.