Hospice of Murray County, Inc
Organization Active NPI Community Based Hospice Care Agency · Slayton, MN
NPI 1477553352 · NPPES record last updated May 6, 2013
Key facts
- NPI
- 1477553352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- HOSPICE OF MURRAY COUNTY, INC
- Practice address
- 36 Park Dr
Slayton, MN 56172-1050 - Phone
- (507) 836-8114
- Fax
- (507) 836-6462
- NPI assigned
- Jul 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Nona Magnussen
- Title
- Administrator
- Phone
- (507) 836-8114
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Practitioners 1
-
Gary Dane Plotz Jr., D.D.S.
Affiliated clinicians 3
-
Josiah A. Goldammer, D.O.
-
Lawrence D Sanchez, M.D.
Medicare Care Compare: Hospice
- Listed as
- Hospice of Murray County Inc
- Ownership
- Non-Profit
- Certified
- Sep 11, 1991
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0920746 | Hospice of Murray County Inc | Certificate of waiver | Oct 8, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospice certification: CCN 241523
- Legal name
- HOSPICE OF MURRAY COUNTY INC.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 11, 1991
- Last certification
- Apr 25, 2019
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 23, 1987 in MN
- Enrollment address
- 36 Park Dr
Slayton, MN 56172-1050
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Loretta Gervais |
Operational/Managerial Control |
Jul 1, 2017 | 1% |
| Lisa Graphenteen |
Operational/Managerial Control |
Jul 1, 2018 | 1% |
| Marti Engelkes |
Corporate Director |
Jun 21, 2021 | |
| Heather Engelkes |
W-2 Managing Employee |
Nov 16, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170208002625 | MN | Part a Provider - Hospice | 1153604525 | Practice locations: Slayton, MN |
National Provider Directory
- Tax ID family
- Our House of Murray County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
36 Park Dr
Slayton, MN 56172-1050
Mailing address
36 Park Dr
PO Box 86
Slayton, MN 56172-1050
Phone (507) 836-8114
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2Z91HO | Other | MN | BLUE CROSS BLUE SHEILD # |
| 124755700 | Medicaid | MN |
Other providers in Slayton, MN
- Amy Goering Fry
- Larry Dean Hafner
- Tracy Lynn Hansen
- Ashley Morgan Hill
- Kathryn Elizabeth Hoffmann
- Leisa Marie Isder
- Rachel Isder
- Lesli I Kramer
- Jennifer Lynn Krikrou
- Maci Kruisselbrink
All providers in Slayton, MN · Community Based Hospice Care Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.