Organization Active NPI

Divine Providence Community Home

  • Skilled Nursing Facility
  • Sleepy Eye, MN
National Provider Identifier
1538155809
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DIVINE PROVIDENCE COMMUNITY HOME
Practice address
700 Third Ave NW
Sleepy Eye, MN 56085
Phone
(507) 794-3011
Fax
(507) 794-3020
NPI assigned
Sep 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Authorized official

Name
Mrs. Jayna Marie Groebner, LNHA
Title
Administrator
Phone
(507) 794-3011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 328233 MN
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

700 Third Ave NW
Sleepy Eye, MN 56085

Mailing address

700 Third Ave NW
Sleepy Eye, MN 56085
Phone (507) 794-3011

Other identifiers 1

IdentifierTypeStateIssuer
356540800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030422000059 MN Part A Provider - Skilled Nursing Facility 0042129850 Practice locations: Sleepy Eye, MN

Skilled nursing facility certification: CCN 245599

Legal name
DIVINE PROVIDENCE COMMUNITY HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1991
Last certification
Mar 4, 2025
Beds
50
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1977 in MN
Enrollment address
700 3Rd Ave NW
Sleepy Eye, MN 56085-1036
Nursing home name
DIVINE PROVIDENCE COMMUNITY HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Divine Providence Community HomeCCN 245599 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5045.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0405117Divine Providence Community Home700 3Rd Ave NW, Sleepy Eye, MN 56085Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

700 3rd Ave NW
Sleepy Eye, MN 56085
Phone (507) 794-3011

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Janet Kosman Individual Corporate OfficerSecretary/Treasurer Nov 13, 2021
Sharon Williams Individual Corporate OfficerPresident Nov 13, 2021
Venkata Krishna Murthy Individual Operational/Managerial Control Feb 1, 1995
Adp of the SNF May 19, 2025
Organization, Chicago, IL Non-profit Adp of the SNF Jun 30, 2022
Jayna Groebner Individual Operational/Managerial Control Aug 26, 2011
Adp of the SNF May 19, 2025
Caryn Haas Individual Corporate DirectorDirector Jul 1, 2024
Margaret Ann Hubler Individual Corporate DirectorDirector Jul 1, 2024
Rita M Butler Individual Corporate OfficerVice President Jul 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1538155809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 THIRD AVE NW",
            "city": "SLEEPY EYE",
            "state": "MN",
            "postal_code": "56085",
            "telephone_number": "507-794-3011",
            "fax_number": "507-794-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 THIRD AVE NW",
            "city": "SLEEPY EYE",
            "state": "MN",
            "postal_code": "56085",
            "telephone_number": "507-794-3011",
            "fax_number": "507-794-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE COMMUNITY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "GROEBNER",
        "authorized_official_first_name": "JAYNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-794-3011",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328233",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356540800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Eye, MN

Sources for this page

Verify at the official NPI Registry.