NPIMap

Organization Active NPI

Saint Elizabeths Hospital of Wabasha Inc

Doing business as Gundersen St. Elizabeth's Hospital and Clinics

  • Skilled Nursing Facility
  • Wabasha, MN
National Provider Identifier
1306864939
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
330781 Issued in MN
Legal business name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
Gundersen St. Elizabeth's Hospital and Clinics
Practice address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone
(651) 565-4531
Fax
(651) 565-2482
NPI assigned
Jul 18, 2006
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ST ELIZABETH'S HOSPITAL OF WABASHA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Mr. John K Wolfe
Title
Cfo
Phone
(651) 565-5553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 330781 MN Primary

Addresses

Primary practice location

1200 Grant Blvd W
Wabasha, MN 55981-1042

Mailing address

1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-4531

Other identifiers 3

IdentifierTypeStateIssuer
NH0451OtherMNUCARE FOR NURSING HOME
82693400MedicaidWI
1895NELOtherMNBCBS NURSING HOME

Other names 1

  • Gundersen St. Elizabeth's Hospital and Clinics Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000811 MN Part B Supplier - Clinic/Group Practice 5092619387 Receives reassigned benefits from 157 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wabasha, MN
O20050907000868 MN Part A Provider - Skilled Nursing Facility 5092619387 Practice locations: Wabasha, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306864939. Details of each certification follow.

Skilled nursing facility certification: CCN 245487

Legal name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
GUNDERSEN ST ELIZABETH'S CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 14, 1986
Last certification
May 21, 2025
Beds
100
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Gundersen Health System
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1965 in MN
Enrollment address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Nursing home name
GUNDERSEN ST ELIZABETH'S CARE CENTER

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 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gundersen St Elizabeth's Care CenterCCN 245487 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Feb 14, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10079.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeths Hosp-Ekg5 organizations share this tax ID, including this one
Part of
St Elizabeths Hosp-Ekg

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2025
Dennis Charles Spano Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Mar 3, 2025
Paul McLellan Individual Corporate DirectorBoard Member Jan 1, 2026
James Root Individual Corporate OfficerCeo Sep 1, 2020
Individual Adp of the SNF Jan 1, 2025
Richard Vaplon Individual Corporate DirectorBoard Member Jan 1, 2026
Bellin Gundersen Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 30, 2022 100%
Operational/Managerial Control Nov 30, 2022 100%
Paul R Fisch Individual Corporate DirectorBoard Member Sep 1, 2020
Emily Durand Individual Corporate DirectorBoard Member Jan 1, 2023
Individual Adp of the SNF Jan 1, 2025
Michael J Ebersold Individual Corporate DirectorBoard Member Jul 1, 2016
Beverly Youngbauer Individual Corporate DirectorBoard Member Jan 1, 2023
Individual Adp of the SNF Jan 1, 2025
John K Wolfe Individual Corporate OfficerFinance Administrator Jan 1, 1992
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2020 100%
Operational/Managerial Control Aug 1, 2020 100%
Individual Adp of the SNF Jan 1, 2025
Kristi Petersen Individual Corporate OfficerAdministrator Jan 1, 2025
Adp of the SNF Mar 3, 2025
Cindy Denk Individual Corporate DirectorBoard Member Oct 1, 2012
Daniel Coenen Individual Corporate DirectorBoard Member Jan 1, 2024
Lloyd Haas Individual Corporate DirectorBoard Member Sep 1, 2020

Owners & managing parties with NPI records 2

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

Facilities with the same owner 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 35

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 35

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": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1306864939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531",
            "fax_number": "651-565-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST ELIZABETH'S HOSPITAL OF WABASHA INC",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-565-5553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "330781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE FOR NURSING HOME",
            "identifier": "NH0451",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82693400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NURSING HOME",
            "identifier": "1895NEL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen St. Elizabeth's Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wabasha, MN

Sources for this page

Verify at the official NPI Registry.