NPIMap

Organization Active NPI

Fairview Health Services

Doing business as UMMC, Fairview (Psych Unit)

  • Psychiatric Hospital Unit
  • Minneapolis, MN
National Provider Identifier
1679121024
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
FAIRVIEW HEALTH SERVICES
Doing business as
UMMC, Fairview (Psych Unit)
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 273-8700
NPI assigned
Aug 29, 2019
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Maureen V Ring
Title
Sys Dir Govt Reimb & Netwk Rel
Phone
(612) 672-6740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary
Psychiatric Hospital 283Q00000X

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (612) 672-6740

Other names 1

  • UMMC, Fairview (Psych Unit) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191220000114 MN Part A Provider - Hospital 1951213057 Practice locations: Minneapolis, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679121024. Details of each certification follow.

Hospital certification: CCN 24S080

Legal name
FAIRVIEW HEALTH SERVICES
Doing business as
FAIRVIEW HOSPITAL UNIVERSITY
Organization structure
CorporationNon-profit
Incorporated
Dec 20, 1972 in MN
Enrollment address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Hospital Psychiatric Unit
Hospital subgroups
Acute care

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

National Provider Directory

National Provider Directory
Tax ID family
Fairview LKS N Brnch CL70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Melissa Ann Geller Individual Corporate DirectorDirector Jan 1, 2024
David Martin Levy Individual Corporate DirectorDirector Jan 1, 2024
Maureen Veronica-Reger Ring Individual Corporate DirectorSystem Director of Pe Jan 1, 2024
W-2 Managing EmployeeSystem Director of Pe Jan 1, 2024
Stephen Jeffrey Swensen Individual Corporate DirectorDirector Jan 1, 2024
Srijoy Mahapatra Individual Corporate DirectorBoard of Director Oct 1, 2024
Jodi Richard Individual Corporate DirectorDirector Jan 1, 2019
Shawntera Monique Hardy Individual Corporate DirectorDirector Jan 1, 2024
Joe Charles Gaylord Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing EmployeeCfo Jan 1, 2024
Kenneth Joseph Roering Individual Corporate DirectorDirector Feb 23, 2017
James Hereford Individual Corporate DirectorDirector Dec 10, 2016
Paul Jr Hill Individual Corporate DirectorDirector Jan 1, 2024
Tami Lynn Reller Individual Corporate DirectorBoard of Director May 9, 2024
Michael Roger Connly Individual Corporate DirectorDirector Jun 1, 2017
Karen Swearingen Richard Individual Corporate DirectorBoard of Director Jan 1, 2025
John Charles Heinmiller Individual Corporate DirectorDirector Jul 1, 2017
Julie S Causey Individual Corporate DirectorDirector Jun 1, 2017
Barclay Edward Berdan Individual Corporate DirectorDirector Jan 1, 2024
Timothy Engel Marx Individual Corporate DirectorDirector Jun 1, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Capitol Park Mental Health HospitalSaint Paul, MN, CCN 244019 Hospital 5% Or Greater Direct Ownership Interest (12.1%) Dec 7, 2021
Accentcare Fairview Home Health - East, LLCOakdale, MN, CCN 247166 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Home Health - West, LLCSaint Paul, MN, CCN 247078 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020
Accentcare Fairview Hospice - West, LLCSaint Paul, MN, CCN 241514 Hospice 5% Or Greater Indirect Ownership Interest (20%) Nov 2, 2020

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1679121024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "612-672-6740",
            "fax_number": "612-884-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-29",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "RING",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SYS DIR GOVT REIMB & NETWK REL",
        "authorized_official_telephone_number": "612-672-6740"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMMC, Fairview (Psych Unit)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UMMC, Fairview (Psych Unit)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.