Monticello-Big Lake Community Hospital

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

338705 Issued in MN

Legal business name

MONTICELLO-BIG LAKE COMMUNITY HOSPITAL

Doing business as

New River Medical Center

Practice address

1013 Hart Blvd
Monticello, MN 55362-8575

Phone

(763) 295-2945

Fax

(763) 271-2299

NPI assigned

Aug 30, 2005

Last updated

Nov 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy C Friesen

Title

Cfo

Phone

(763) 271-2303

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New River Medical Center Doing business as

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1427041052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "763-295-2945",
            "fax_number": "763-271-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "763-295-2945",
            "fax_number": "763-271-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO-BIG LAKE COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "FRIESEN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "763-271-2303",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "338705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155047100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monticello Dentistry PLLC
• Monticello Family Dentistry LLC
• Monticello Optical Center Inc.
• Monticello Physical Therapy & Sports Medicine, LLC (Monticello Physical Therapy)
• Monticello-Big Lake Anesthesiology
• Monticello-Big Lake Community Hospital (New River Medical Center)
• Monticello-Big Lake Hospital (New River Medical Center)
• Ezzat Ahmed Moussa, MD
• Mary Beth Neisen, FNP-BC
• Mark D Nelson, DPM

• Critical Access Hospital in Monticello, MN
• Providers in Monticello, MN by specialty
• Critical Access Hospital in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.