NPIMap

Organization Active NPI

County of Murray

Doing business as Murray County Clinic

  • Clinic/Center
  • Slayton, MN
National Provider Identifier
1679565287
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COUNTY OF MURRAY
Doing business as
Murray County Clinic
Practice address
2040 Juniper Ave
Slayton, MN 56172-1017
Phone
(507) 836-6153
Fax
(507) 836-8787
NPI assigned
Aug 19, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF MURRAYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mel Snow
Title
Administrator Ceo
Phone
(507) 836-1277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MN Primary

Addresses

Primary practice location

2040 Juniper Ave
Slayton, MN 56172-1017

Mailing address

2040 Juniper Ave
Slayton, MN 56172-1017
Phone (507) 836-6153

Other names 1

  • Murray County Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040211000401 MN Part B Supplier - Clinic/Group Practice 7810806064 Receives reassigned benefits from 46 practitioners
1 other NPI on this enrollment
Practice locations: Slayton, MN
O20040421001282 MN Part A Provider - Rural Health Clinic 7810806064 Practice locations: Slayton, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679565287. Details of each certification follow.

Rural health clinic certification: CCN 243417

Legal name
COUNTY OF MURRAY
Doing business as
SLAYTON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 1, 2000
Last certification
Aug 28, 2012
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Incorporated
in MN
Enrollment address
2042 Juniper Ave
Slayton, MN 56172-1017

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Murray Cty Mem Hosp

Member organizations 1

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

Locations

2711 Broadway Ave
Slayton, MN 56172
Phone (507) 836-6262

1680 Diagonal Rd
Worthington, MN 56187
Phone (507) 372-3800

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Robyn Van Heuvelen Individual Corporate OfficerCfo Jan 1, 2018
W-2 Managing EmployeeCfo Jan 1, 2018
Luke D Schryvers Individual Corporate OfficerCeo Dec 2, 2020
County of Murray Organization, Slayton, MN 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Operational/Managerial Control Jan 31, 2006

Owners & managing parties with NPI records 1

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

  • County of Murray

    dba Murray County Memorial Hospital

    • Critical Access Hospital
    • Slayton, MN
    • NPI 1053497214

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Murray County Memorial HospitalSlayton, MN, CCN 241319 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 30, 2007
Murray County Memorial HospitalSlayton, MN, CCN 24Z319 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 1950

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Murray

    dba Murray County Memorial Hospital

    • Critical Access Hospital
    • Slayton, MN
    • NPI 1053497214

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679565287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 JUNIPER AVE",
            "city": "SLAYTON",
            "state": "MN",
            "postal_code": "561721017",
            "telephone_number": "507-836-6153",
            "fax_number": "507-836-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 JUNIPER AVE",
            "city": "SLAYTON",
            "state": "MN",
            "postal_code": "561721017",
            "telephone_number": "507-836-6153",
            "fax_number": "507-836-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MURRAY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MURRAY",
        "enumeration_date": "2005-08-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "MEL",
        "authorized_official_title_or_position": "ADMINISTRATOR  CEO",
        "authorized_official_telephone_number": "507-836-1277"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Murray County Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Slayton, MN

Sources for this page

Verify at the official NPI Registry.