NPIMap

Organization Active NPI

Stevens Community Medical Center Inc

Doing business as Stevens Community Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Morris, MN
National Provider Identifier
1649705690
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
STEVENS COMMUNITY MEDICAL CENTER INC
Doing business as
Stevens Community Medical Center
Practice address
400 E. 1St Street
Morris, MN 56267
Phone
(320) 589-1313
Fax
(320) 589-1065
NPI assigned
Apr 27, 2017
Last updated
Dec 3, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
STEVENS COMMUNITY MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Authorized official

Name
John D Rau
Title
Ceo/President
Phone
(320) 589-1313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

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 1

  • Stevens Community Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220816003038 MN Part A Provider - Critical Access Hospital 3678475852 Receives reassigned benefits from 1 practitioner
Practice locations: Morris, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649705690. Details of each certification follow.

Hospital certification: CCN 24Z363

Legal name
STEVENS COMMUNITY MEDICAL CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1994 in MN
Enrollment address
400 E 1St St
Morris, MN 56267-1408
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Part of
Stevens Comm Mem Hosp

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Paul Martin Individual Corporate DirectorBoard Member Mar 1, 2008
Kerrie McEvilly Individual Corporate OfficerCoo Jun 1, 2020
Brent B Barnstuble Individual Operational/Managerial ControlMD Sep 1, 2024
Timothy Jay Individual Operational/Managerial ControlMD Mar 1, 2025
Bart Finzel Individual Corporate DirectorBoard Member Nov 19, 2007
Ward Voorhees Individual Corporate DirectorBoard Member Mar 21, 2005
Sarah Tahtinen Individual Corporate Officer Oct 16, 2025
Corporate Director Oct 16, 2025
Operational/Managerial Control Oct 16, 2025
David Paul Individual Corporate DirectorBoard Member Mar 21, 2005
Toby Christie-Perkins Individual Operational/Managerial ControlBoard Member Nov 1, 2016
Jodi Decamp Individual Corporate DirectorBoard Member Mar 31, 2005
Darryl Larson Individual Corporate DirectorBoard Member Jan 1, 2012
Jan Hagen Individual Corporate DirectorBoard Member Nov 19, 2017
Rachel Johnson Individual Operational/Managerial ControlBoard Member Jun 1, 2019

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 144

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 144

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1649705690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E. 1ST STREET",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "56267",
            "telephone_number": "320-589-1313",
            "fax_number": "320-589-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E. 1ST STREET",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "56267",
            "telephone_number": "320-589-1313",
            "fax_number": "320-589-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS COMMUNITY MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEVENS COMMUNITY MEDICAL CENTER INC",
        "enumeration_date": "2017-04-27",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "RAU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "320-589-1313"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevens Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stevens Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morris, MN

Sources for this page

Verify at the official NPI Registry.