Organization Active NPI

Pioneer Home Incorporated

  • Skilled Nursing Facility
  • Fergus Falls, MN
National Provider Identifier
1669448254
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PIONEER HOME INCORPORATED
Practice address
1131 S Mabelle Ave
Fergus Falls, MN 56537-3723
Phone
(218) 998-1500
Fax
(218) 998-1580
NPI assigned
Feb 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Authorized official

Name
Cindy Kacer
Title
A/R Specialist
Phone
(218) 998-1540

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 8090221ADC MN
Assisted Living Facility 310400000X FLB001784712556 MN
Assisted Living Facility 310400000X 1064141-1-ADC MN
Skilled Nursing Facility 314000000X 328217 MN
Skilled Nursing Facility 314000000X Primary
Emergency Response System Companies 333300000X

Addresses

Primary practice location

1131 S Mabelle Ave
Fergus Falls, MN 56537-3723

Mailing address

1006 S Sheridan St
Fergus Falls, MN 56537-3518
Phone (218) 739-7700

Other identifiers 3

IdentifierTypeStateIssuer
7100383OtherMNMEDICA PROVIDER NUMBER
707342900MedicaidMN
9668PIOtherMNBCBS PROVIDER NUMBER

Other names 1

  • Pioneer Retirement Community Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 218.998.1580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100624000462 MN Part A Provider - Skilled Nursing Facility 5496886111 Practice locations: Fergus Falls, MN

Skilled nursing facility certification: CCN 245463

Legal name
PIONEER HOME INCORPORATED
Doing business as
PIONEERCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 11, 1987
Last certification
Jul 24, 2024
Beds
105
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 7, 1928 in MN
Enrollment address
1131 S Mabelle Ave
Fergus Falls, MN 56537-3723
Nursing home name
PIONEER CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pioneer Care CenterCCN 245463
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 11, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10591.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0671739Pioneer Home Inc1131 South Mabelle Ave, Fergus Falls, MN 56537Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 27

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

NameRoleSinceShare
Nathan D Johnson Individual Corporate DirectorCeo Nov 3, 2009 100%
Operational/Managerial ControlCeo Nov 3, 2009 100%
Managing Control - Governing BodyCeo Nov 3, 2009
Adp of the SNF Nov 3, 2009
Elizabeth Pederson Individual Operational/Managerial Control Sep 17, 2021
Linda Lee Individual Operational/Managerial Control Nov 22, 1982
Adp of the SNF Nov 22, 1982
Organization, Plymouth, MN Management services company, Consulting firm, For-profit Adp of the SNF Jan 19, 2026
Sara Watkins Individual Operational/Managerial Control Nov 2, 2009
Adp of the SNF Nov 2, 2009
Karen Mellum Individual Corporate Officer Apr 1, 2025
Managing Control - Governing BodyCorporate Board Director Apr 1, 2025
Organization, Edina, MN LLC, Management services company, Consulting firm, Non-profit Adp of the SNF Jan 19, 2026
Joe Ellig Individual Corporate Officer Apr 1, 2020
Managing Control - Governing BodyCorporate Board Director Apr 1, 2020
Kari Johnson Individual Corporate Officer Apr 1, 2025
Managing Control - Governing BodyCorporate Board Director Apr 1, 2025
Janet Freeman Individual Corporate Officer Apr 1, 2019
Managing Control - Governing BodyCorporate Board Director Apr 1, 2019
Organization, Oakdale, MN Consulting firm Adp of the SNF Jan 19, 2026
Tyler a Lacey Individual Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Organization, Murfreesboro, TN Corporation Adp of the SNF Jan 20, 2026
Lori Nelson Individual Corporate OfficerOffice Manager Feb 7, 2023
Adp of the SNF Feb 7, 2023
April Hocum Individual Operational/Managerial Control Dec 1, 2025
Katie Hunter Individual Operational/Managerial Control Oct 24, 2012
Jeff Ackerson Individual Corporate Director Apr 1, 2018
Managing Control - Governing BodyCorporate Board Chair Apr 1, 2018
Aegis Therapies, Inc. Organization, Frisco, TX Corporation, Medical provider/supplier Adp of the SNF Jun 1, 2021
Brandi Sillerud Individual Corporate Officer Apr 1, 2018
Managing Control - Governing BodyCorporate Board Director Apr 1, 2018
Julia Nowacki Individual Operational/Managerial Control Apr 8, 2024
Adp of the SNF Apr 8, 2024
Lowell Brenna Individual Corporate Officer Apr 1, 2021
Managing Control - Governing BodyCorporate Board Director Apr 1, 2021
Dean Monke Individual Corporate Officer Apr 1, 2020
Managing Control - Governing BodyCorporate Board Director Apr 1, 2020
Holly Schmidt Individual Operational/Managerial Control Jul 2, 2018
Catherine Walz Individual Operational/Managerial Control Feb 6, 2023
Brad Bushinger Individual Operational/Managerial Control Jan 2, 1996
John Sethre Individual Corporate Officer Apr 2, 2020
Managing Control - Governing BodyCorporate Board Director Apr 2, 2020
Suzanne Demuth Individual Corporate Officer Apr 1, 2020
Managing Control - Governing BodyCorporate Board Director Apr 1, 2020

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 9

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

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1669448254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 S SHERIDAN ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373518",
            "telephone_number": "218-739-7700",
            "fax_number": "218-739-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S MABELLE AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373723",
            "telephone_number": "218-998-1500",
            "fax_number": "218-998-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HOME INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "KACER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "A/R SPECIALIST",
        "authorized_official_telephone_number": "218-998-1540"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "8090221ADC",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "FLB001784712556",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "1064141-1-ADC",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328217",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "333300000X",
            "taxonomy_group": "",
            "desc": "Emergency Response System Companies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "7100383",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707342900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "9668PI",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "218.998.1580",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "address_1": "1131 S Mabelle Ave",
            "city": "Fergus Falls",
            "state": "MN",
            "country_code": "US",
            "postal_code": "565373723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pioneer Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pioneer Retirement Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.