NPIMap

River'S Edge Hospital & Clinic

Organization Active NPI Critical Access Hospital · St Peter, MN

NPI 1407849367 · NPPES record last updated Feb 11, 2009

Key facts

NPI
1407849367
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
327494 (MN)
Legal business name
RIVER'S EDGE HOSPITAL & CLINIC
Practice address
1900 Sunrise Dr
St Peter, MN 56082-5376
Phone
(507) 931-2200
Fax
(507) 934-8505
NPI assigned
Aug 25, 2005
Organization subpart
No

Authorized official

Name
Ms. Colleen Spike
Title
Ceo
Phone
(507) 934-7602

Other NPIs with the same Medicare PAC ID 1

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

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

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 107

Affiliated clinicians 87

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

View all 87

Medicare Care Compare: Hospital

Listed as
River'S Edge Hospital & Clinic CCN 241334
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MN

Hospital certification: CCN 241334

Legal name
RIVER'S EDGE HOSPITAL & CLINIC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 1, 2002
Last certification
Apr 27, 2017
Beds
17
Ownership / control type
Local
Organization structure
Other · Non-profit
Incorporated
in MN
Enrollment address
1900 North Sunrise Drive
Saint Peter, MN 56082-5376
Other Hospital Practice Location

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Paula Meskan
Individual 		Corporate Officer
Ceo		 Sep 1, 2020
W-2 Managing Employee Sep 1, 2020
City of St Peter
Organization · St. Peter, MN
Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2020 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031120000094 MN Part B Supplier - Clinic/Group Practice 7214849397 Receives reassigned benefits from 94 practitioners
Practice locations: Saint Peter, MN
O20090204000094 MN Part a Provider - Critical Access Hospital 7214849397 Receives reassigned benefits from 58 practitioners
Practice locations: Saint Peter, MN

National Provider Directory

Locations

200 E Bowler St
Le Center, MN 56057
Phone (507) 357-2323

1900 Sunrise Dr
#D
Saint Peter, MN 56082

1901 Sunrise Dr
Saint Peter, MN 56082

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 327494 MN Yes

Addresses

Primary practice location

1900 Sunrise Dr
St Peter, MN 56082-5376

Mailing address

1900 Sunrise Dr
St Peter, MN 56082-5376
Phone (507) 931-2200

Other identifiers

IdentifierTypeStateIssuer
650547300MedicaidMN
224267200MedicaidMN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 11, 2009.

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1407849367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SUNRISE DR",
            "city": "ST PETER",
            "state": "MN",
            "postal_code": "560825376",
            "telephone_number": "507-931-2200",
            "fax_number": "507-934-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SUNRISE DR",
            "city": "ST PETER",
            "state": "MN",
            "postal_code": "560825376",
            "telephone_number": "507-931-2200",
            "fax_number": "507-934-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER'S EDGE HOSPITAL & CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2009-02-11",
        "status": "A",
        "authorized_official_last_name": "SPIKE",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-934-7602",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "327494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650547300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224267200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Peter, MN

All providers in St Peter, MN · Critical Access Hospital in Minnesota

Sources for this page

Verify at the official NPI Registry.