NPIMap

Organization Active NPI

Kittson Memorial Hospital Association

  • Critical Access Hospital
  • Hallock, MN
National Provider Identifier
1669403846
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
365415 Issued in MN
Legal business name
KITTSON MEMORIAL HOSPITAL ASSOCIATION
Doing business as
KITTSON MEMORIAL HOSPITAL Association
Practice address
1010 S Birch Ave
Hallock, MN 56728-4215
Phone
(218) 843-3612
NPI assigned
Jul 5, 2006
Last updated
Jul 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Authorized official

Name
Andrea Swenson
Title
Ceo
Phone
(218) 843-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 365415 MN Primary

Addresses

Primary practice location

1010 S Birch Ave
Hallock, MN 56728-4215

Mailing address

1010 S Birch Ave
Hallock, MN 56728-4215
Phone (218) 843-3612

Other identifiers 1

IdentifierTypeStateIssuer
738745800MedicaidMN

Other names 1

  • KITTSON MEMORIAL HOSPITAL Association Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031208000645 MN Part B Supplier - Clinic/Group Practice 1355251315 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Hallock, MN; Karlstad, MN
O20210614001210 MN Part A Provider - Critical Access Hospital 1355251315 Receives reassigned benefits from 7 practitioners
Practice locations: Hallock, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669403846. Details of each certification follow.

Hospital certification: CCN 241336

Legal name
KITTSON MEMORIAL HOSPITAL ASSOCIATION
Doing business as
KITTSON MEMORIAL HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 1, 2002
Last certification
May 31, 2018
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1922 in MN
Enrollment address
1010 S Birch Ave
Hallock, MN 56728-4215
Other Hospital Practice Location

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).

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Kittson HealthcareCCN 241336 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

250 Thompson St
Saint Paul, MN 55102
Phone (651) 297-6504

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Sandy Wilson Individual Corporate Director Aug 8, 2018
Henry H Escareno Individual Corporate Director Jan 7, 2025
Samul L Grandstrand Individual Corporate Director Apr 4, 2025
Hugh Hunt Individual Corporate DirectorDirector Jan 21, 2019
George H Hanson Individual Corporate Director Apr 4, 2025
Michael Swanson Individual Corporate Director Jul 26, 2022
Carlene L Cole Individual W-2 Managing EmployeeHim Manager Apr 23, 1990
Stacy Diamond Individual Corporate Director Feb 26, 2023
Betty Younggren Individual Corporate Director Apr 4, 2025
Andrea Swenson Individual Corporate OfficerCeo Apr 7, 2023
Kenny Hultgren Individual Corporate Director Feb 26, 2023
Crisa Mortenson Individual W-2 Managing EmployeeBusiness Office Manager Jan 1, 2026

Practitioners & affiliated clinicians

Practitioners 13

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 13

Affiliated clinicians 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751500800000",
    "number": "1669403846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S BIRCH AVE",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "567284215",
            "telephone_number": "218-843-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S BIRCH AVE",
            "city": "HALLOCK",
            "state": "MN",
            "postal_code": "567284215",
            "telephone_number": "218-843-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITTSON MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "SWENSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-843-3612"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "365415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "738745800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KITTSON MEMORIAL HOSPITAL Association",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KITTSON MEMORIAL HOSPITAL Association",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hallock, MN

Sources for this page

Verify at the official NPI Registry.