Monticello-Big Lake Community Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

328129 Issued in MN

Legal business name

MONTICELLO-BIG LAKE COMMUNITY HOSPITAL

Doing business as

New River Medical Center

Practice address

1104 E River St
Monticello, MN 55362-8762

Phone

(763) 295-5116

NPI assigned

Aug 24, 2005

Last updated

Jul 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Pawelk

Title

Director of Business Office

Phone

(763) 271-2306

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• New River Medical Center Doing business as

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1588657696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 E RIVER ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628762",
            "telephone_number": "763-295-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E RIVER ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628762",
            "telephone_number": "763-295-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO-BIG LAKE COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "PAWELK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "763-271-2306",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053843400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monticello Family Dentistry LLC
• Monticello Optical Center Inc.
• Monticello Physical Therapy & Sports Medicine, LLC (Monticello Physical Therapy)
• Monticello-Big Lake Anesthesiology
• Monticello-Big Lake Community Hospital (New River Medical Center)
• Monticello-Big Lake Hospital (New River Medical Center)
• Ezzat Ahmed Moussa, MD
• Mary Beth Neisen, FNP-BC
• Mark D Nelson, DPM
• Glenn G Nemec, MD

• Skilled Nursing Facility in Monticello, MN
• Providers in Monticello, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.