Stevens Community Medical Center Inc
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Morris, MN
NPI 1649705690 · NPPES record last updated Dec 3, 2018
Key facts
- NPI
- 1649705690
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- Legal business name
- STEVENS COMMUNITY MEDICAL CENTER INC
- Practice address
- 400 E. 1St Street
Morris, MN 56267 - Phone
- (320) 589-1313
- Fax
- (320) 589-1065
- NPI assigned
- Apr 27, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- STEVENS COMMUNITY MEDICAL CENTER INC
Authorized official
- Name
- John D Rau
- Title
- Ceo/President
- Phone
- (320) 589-1313
Owners & managing parties with NPI records 3
-
Timothy Jay, MD
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 2
Practitioners 156
-
Hannah Jane Johnson, DNP, APRN, FNP-BC
-
Amy Lynn Brandt, DNP, ONP-C
-
Bryan James Brindley, M.D.
-
Nathan B Danielson, D.O.
-
Thomas James Davis, M.D.
-
Rebecca Renee Dehart, D.P.M.
-
James Dickinson, M.D.
-
Bonnie P Fines, M.D.
-
John Fox III, MD
-
David Gibbons, DO
-
Amee Gibson, DPM
-
Paige W Hardy, CNM
-
Leslie Hartman, M.D.
-
Brad Douglas Hilger, M.D.
-
Nathan B Hoffman, MD
-
Timothy Jay, MD
-
Roman Hystad Keller, D.O.
-
Francis X. Kigozi, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospital certification: CCN 24Z363
- Legal name
- STEVENS COMMUNITY MEDICAL CENTER INC
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 1, 1994 in MN
- Enrollment address
- 400 E 1St St
Morris, MN 56267-1408
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Paul Martin |
Corporate Director |
Mar 1, 2008 | |
| Kerrie McEvilly |
Corporate Officer |
Jun 1, 2020 | |
| Brent B Barnstuble |
Operational/Managerial Control |
Sep 1, 2024 | |
| Timothy Jay |
Operational/Managerial Control |
Mar 1, 2025 | |
| Bart Finzel |
Corporate Director |
Nov 19, 2007 | |
| Ward Voorhees |
Corporate Director |
Mar 21, 2005 | |
| Sarah Tahtinen |
Corporate Officer | Oct 16, 2025 | |
| Corporate Director | Oct 16, 2025 | ||
| Operational/Managerial Control | Oct 16, 2025 | ||
| David Paul |
Corporate Director |
Mar 21, 2005 | |
| Toby Christie-Perkins |
Operational/Managerial Control |
Nov 1, 2016 | |
| Jodi Decamp |
Corporate Director |
Mar 31, 2005 | |
| Darryl Larson |
Corporate Director |
Jan 1, 2012 | |
| Jan Hagen |
Corporate Director |
Nov 19, 2017 | |
| Rachel Johnson |
Operational/Managerial Control |
Jun 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220816003038 | MN | Part a Provider - Critical Access Hospital | 3678475852 |
Receives reassigned benefits from 1 practitioner Practice locations: Morris, MN |
National Provider Directory
- Part of
- Stevens Community Medic
Locations
7900 Chapin Dr NE
New London, MN 56273
Phone (320) 347-1212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Yes |
Addresses
Primary practice location
400 E. 1St Street
Morris, MN 56267
Mailing address
400 E. 1St Street
Morris, MN 56267
Phone (320) 589-1313
Other names
- Stevens Community Medical Center
Other providers in Morris, MN
- Richard Bruce Stark
- Kevin Stefanek
- Katelyn Steinlicht
- Stevens Community Medical Center Inc
- Stevens Community Medical Center Inc
- Stevens Community Medical Center Inc
- Stevens County Ambulance
- Stevens County Human Services
- Stevens Traverse Grant Public Health
- John Frederick Stock
All providers in Morris, MN · Medicare Defined Swing Bed Hospital Unit in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2018. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.