NPIMap

Organization Active NPI

Mille Lacs Health System

Doing business as Critical Access Hospital

  • Critical Access Hospital
  • Onamia, MN
National Provider Identifier
1548212699
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
331503 Issued in MN
Legal business name
MILLE LACS HEALTH SYSTEM
Doing business as
Critical Access Hospital
Practice address
200 Elm St N
Onamia, MN 56359-7901
Phone
(320) 532-3154
Fax
(320) 532-3111
NPI assigned
May 17, 2006
Last updated
Apr 26, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
MILLE LACS HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
Mr. John W Unzen
Title
Cfo
Phone
(320) 532-2581

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 343531 MN
Critical Access Hospital 282NC0060X 331503 MN Primary
Emergency Medicine Physician 207P00000X NU
Surgery Physician 208600000X NU
Institutional Pharmacy 3336I0012X 201047-0 MN

Addresses

Primary practice location

200 Elm St N
Onamia, MN 56359-7901

Mailing address

200 Elm St N
PO Box a
Onamia, MN 56359-7901
Phone (320) 532-3154

Other identifiers 5

IdentifierTypeStateIssuer
52204COOtherMNBLUE CROSS HOSPITAL
5012782OtherMNMEDICA
190247400MedicaidMN
1006091OtherMNPREFERRED ONE
33523MIOtherMNBLUE CROSS CLINICS

Other names 1

  • Critical Access Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000052 MN Part B Supplier - Clinic/Group Practice 4789577834 Receives reassigned benefits from 133 practitioners
9 other NPIs on this enrollment
Practice locations: Milaca, MN; Princeton, MN; Onamia, MN; Isle, MN; Hillman, MN; Garrison, MN
O20070910000977 MN Part A Provider - Critical Access Hospital 4789577834 Receives reassigned benefits from 161 practitioners
Practice locations: Milaca, MN; Onamia, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548212699. Details of each certification follow.

Hospital certification: CCN 241356

Legal name
MILLE LACS HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2004
Last certification
Aug 14, 2024
Beds
31 (28 certified)
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jun 20, 1990 in MN
Enrollment address
200 Elm St N
Onamia, MN 56359-7901

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

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mille Lacs Health SystemCCN 241356 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
MLHS Geropsychiatric Unit

Locations

27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Robert Dubbs Individual Corporate Director Jan 1, 2017
Rebecca K Fossand Individual Corporate DirectorCao Jan 4, 2016
Amy S Ninham Individual W-2 Managing EmployeeCfo Mar 10, 2025
Elizabeth J Lundquist Individual Corporate DirectorBoard Member Jan 1, 2013
Andrew Knutson Individual Corporate OfficerCeo Jan 27, 2025
W-2 Managing EmployeeCeo Jan 27, 2025
Robert a Athman Individual Corporate DirectorBoard Member Jan 1, 2025
Jean M Stafford Individual Corporate Director Jan 13, 2022
Roger W Tramm Individual Corporate Director Jan 1, 2023
Anthony Hass Individual Corporate DirectorBoard Member Jan 1, 2023
Tracy L Sam Individual Corporate Director Jan 1, 2024
Louis P Gravel Individual Corporate DirectorBoard Member Jan 12, 2012
Patti J Hook Individual Corporate DirectorBoard Member Sep 1, 1991
Arden Virnig Individual W-2 Managing EmployeeMD Nov 29, 2007
Dennis Burr Individual Corporate Director Jan 1, 2017

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cura of OnamiaOnamia, MN, CCN 245127 Skilled nursing facility Adp of the SNF Jul 22, 2002
Mille Lacs Health SystemOnamia, MN, CCN 241588 Hospice Operational/Managerial Control Jun 17, 2009
Mille Lacs Health SystemIsle, MN, CCN 243975 Rural health clinic Operational/Managerial Control Sep 10, 2008
Mille Lacs Health SystemOnamia, MN, CCN 243976 Rural health clinic Operational/Managerial Control Sep 9, 2008

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 211

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 211

Affiliated clinicians 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1548212699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "address_2": "PO BOX A",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154",
            "fax_number": "320-532-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLE LACS HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLE LACS HEALTH SYSTEM",
        "enumeration_date": "2006-05-17",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "UNZEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-532-2581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "343531",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "331503",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MN",
            "license": "201047-0",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HOSPITAL",
            "identifier": "52204CO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5012782",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190247400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1006091",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CLINICS",
            "identifier": "33523MI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Critical Access Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Onamia, MN

Sources for this page

Verify at the official NPI Registry.