Active NPI
Samaritan Bethany Inc
- Skilled Nursing Facility
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SAMARITAN BETHANY INC
- Practice address
- 24 8TH St NW
Rochester, MN 55901-6817 - Phone
- (507) 289-5042
- Fax
- (507) 289-6545
- NPI assigned
- Jul 21, 2006
- Last updated
- Jul 2, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kyla Berg
- Title
- Co-Mission Leader
- Phone
- (507) 289-5042
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
24 8TH St NW
Rochester, MN 55901-6817
Mailing address
24 8TH St NW
Rochester, MN 55901-6817
Phone (507) 289-5042
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 851863200 | Medicaid | MN | |
| 8782SA | Other | MN | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080520000786 | MN | Part A Provider - Skilled Nursing Facility | 8325117054 | Practice locations: Rochester, MN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1467473272. Details of each certification follow.
Skilled nursing facility certification: CCN 245530
- Legal name
- SAMARITAN BETHANY INC
- Doing business as
- SAMARITAN BETHANY HOME ON 8TH
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 1988
- Last certification
- Dec 12, 2024
- Beds
- 128
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 14, 1971 in MN
- Enrollment address
- 24 8TH St NW
Rochester, MN 55901-6817 - Nursing home name
- SAMARITAN BETHANY HOME ON EIGHTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Samaritan Bethany Home on Eighth
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- May 1, 1988
- Medicare certification status
- Active
- Certified beds
- 128
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0404215 | Samaritan Bethany Home on Eighth | Certificate of waiver | Mar 2, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jerry W Swanson | Corporate Officer | Apr 22, 2019 | |
| Corporate Director | Apr 22, 2019 | ||
| Gary Zander | Corporate Officer | Apr 22, 2019 | |
| Corporate Director | Apr 22, 2019 | ||
| Brandon Miller | Corporate Officer | Feb 5, 2010 | |
| W-2 Managing Employee | Feb 5, 2010 | ||
| Karen Hartman | Corporate Officer | Apr 27, 2020 | |
| Corporate Director | Apr 27, 2020 | ||
| Joseph Phillips | Corporate Officer | Jun 27, 2022 | |
| Corporate Director | Jun 27, 2022 | ||
| Jerad Faudi | Corporate Officer | Apr 26, 2021 | |
| Corporate Director | Apr 26, 2021 | ||
| Kyla Berg | W-2 Managing Employee | Mar 26, 2012 | |
| Susan Knutson | Corporate Officer | Feb 5, 2010 | |
| W-2 Managing Employee | Mar 17, 2008 | ||
| Rachel I Dunn | Corporate Officer | Apr 25, 2016 | |
| Corporate Director | Apr 25, 2016 | ||
| John Haug | Corporate Officer | Apr 26, 2021 | |
| Corporate Director | Apr 26, 2021 | ||
| Kirby Bakken | Corporate Officer | Apr 27, 2020 | |
| Corporate Director | Apr 27, 2020 | ||
| Terry Bird | Corporate Officer | Jul 24, 2017 | |
| Corporate Director | Jul 24, 2017 | ||
| Pamela Shulze | Corporate Officer | Apr 26, 2021 | |
| Corporate Director | Apr 26, 2021 | ||
| Laurie Deyoung | Corporate Officer | Aug 28, 2017 | |
| Corporate Director | Aug 28, 2017 | ||
| Robert Beaulieu | Corporate Officer | Apr 27, 2020 | |
| Corporate Director | Apr 27, 2020 | ||
| Beverly Moravec | Corporate Officer | Aug 22, 2022 | |
| Corporate Director | Aug 22, 2022 | ||
| Scott Davis | Corporate Officer | Apr 28, 2014 | |
| Corporate Director | Apr 28, 2014 |
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Internal Medicine Physician
- Rochester, MN
- NPI 1992960546
-
- Internal Medicine Physician
- Rochester, MN
- NPI 1154550200
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Rochester, MN
- NPI 1598742306
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Rochester, MN
- NPI 1447699400
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751414400000",
"number": "1467473272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 8TH ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559016817",
"telephone_number": "507-289-5042",
"fax_number": "507-289-6545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 8TH ST NW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559016817",
"telephone_number": "507-289-5042",
"fax_number": "507-289-6545"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAMARITAN BETHANY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-21",
"last_updated": "2025-07-02",
"certification_date": "2025-07-02",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "KYLA",
"authorized_official_title_or_position": "CO-MISSION LEADER",
"authorized_official_telephone_number": "507-289-5042",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "851863200",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8782SA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.