NPIMap

Organization Active NPI

Ortonville Area Health Services

  • Critical Access Hospital Clinic/Center
  • Ortonville, MN
National Provider Identifier
1477799765
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
Legal business name
ORTONVILLE AREA HEALTH SERVICES
Practice address
450 Eastvold Ave
Ortonville, MN 56278-1252
Phone
(320) 839-2502
Fax
(320) 839-4105
NPI assigned
Dec 17, 2008
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Mr. David Rogers
Title
Administrator
Phone
(320) 839-2502

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MN
Critical Access Hospital Clinic/Center 261QC0050X MN Primary
Multi-Specialty Clinic/Center 261QM1300X MN
Primary Care Clinic/Center 261QP2300X MN

Addresses

Primary practice location

450 Eastvold Ave
Ortonville, MN 56278-1252

Mailing address

450 Eastvold Ave
Ortonville, MN 56278-1252
Phone (320) 839-2502

Other identifiers 6

IdentifierTypeStateIssuer
05647N0OtherMNBLUE CROSS BLUE SHIELD
106639P499OtherMNUCARE
73143OtherMNHEALTH PARTNERS
9174004OtherDAKOTACARE
001120113OtherMNPRIMEWEST HEALTH
794447100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090326000381 MN Part B Supplier - Clinic/Group Practice 2365448768 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Ortonville, MN
O20130927000701 SD Part B Supplier - Clinic/Group Practice 2365448768 Receives reassigned benefits from 8 practitioners
Practice locations: Milbank, SD

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

405 Eastvold Ave
Ortonville, MN 56278

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1477799765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781252",
            "telephone_number": "320-839-2502",
            "fax_number": "320-839-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 EASTVOLD AVE",
            "city": "ORTONVILLE",
            "state": "MN",
            "postal_code": "562781252",
            "telephone_number": "320-839-2502",
            "fax_number": "320-839-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTONVILLE AREA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-17",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-839-2502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "MN",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05647N0",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "106639P499",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "73143",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9174004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST HEALTH",
            "identifier": "001120113",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "794447100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ortonville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.