NPIMap

Organization Active NPI

Saint Elizabeths Hospital of Wabasha Inc

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

  • Rural Health Clinic/Center
  • Wabasha, MN
National Provider Identifier
1477068914
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
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) 565-5600
Fax
(651) 565-5670
NPI assigned
Dec 6, 2017
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT ELIZABETHS HOSPITAL OF WABASHA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1200 Grant Blvd W
Wabasha, MN 55981-1042

Mailing address

1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-5600

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
O20171215000803 MN Part A Provider - Rural Health Clinic 5092619387 Practice locations: Wabasha, MN
O20260402000230 MN DME Supplier - Physician - Optometrist 5092619387 Practice locations: Wabasha, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477068914. Details of each certification follow.

Rural health clinic certification: CCN 243484

Legal name
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Doing business as
GUNDERSEN ST ELIZABETH'S HOSPITAL AND CLINICS - WABASHA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 30, 2018
Last certification
Jun 26, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1965 in MN
Enrollment address
1200 Grant Blvd W
Wabasha, MN 55981-1042
Related CCNs
241335

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
St Elizabeths Hosp Wabasha5 organizations share this tax ID, including this one
Part of
St Elizabeths Hosp Wabasha

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 13

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

NameRoleSinceShare
Paul McLellan Individual Corporate DirectorBoard Member Jan 1, 2026
James Root Individual Corporate DirectorAdministrator Sep 1, 2020
W-2 Managing EmployeeAdministrator Jan 1, 2007
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 Director Jan 1, 2023
Reece Rykal Individual Corporate DirectorBoard Member Jan 1, 2025
Michael J Ebersold Individual Corporate DirectorBoard Member Jul 1, 2016
Beverly Youngbauer Individual Corporate Director Jan 1, 2023
John K Wolfe Individual Corporate OfficerCfo Jan 1, 1992
W-2 Managing Employee Jan 1, 1992
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2020 100%
Operational/Managerial Control Aug 1, 2020 100%
Cindy Denk Individual Corporate DirectorBoard Secretary/Treasurer Oct 1, 2012
Daniel Coenen Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1477068914",
    "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": "651-565-5600",
            "fax_number": "651-565-5670"
        },
        {
            "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": "651-565-5600",
            "fax_number": "651-565-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ELIZABETHS HOSPITAL OF WABASHA INC",
        "enumeration_date": "2017-12-06",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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.