NPIMap

Organization Active NPI

Appleton Area Health

  • Rural Health Clinic/Center
  • Appleton, MN
National Provider Identifier
1730126673
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
APPLETON AREA HEALTH
Practice address
30 S. Behl St.
Appleton, MN 56208
Phone
(320) 289-1580
Fax
(320) 289-8538
NPI assigned
May 31, 2006
Last updated
May 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Jacob William Redepenning
Title
Cfo
Phone
(320) 289-8514

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MN
Rural Health Clinic/Center 261QR1300X MN Primary

Addresses

Primary practice location

30 S. Behl St.
Appleton, MN 56208

Mailing address

30 S. Behl St.
Appleton, MN 56208
Phone (320) 289-1580

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060818000114 MN Part B Supplier - Clinic/Group Practice 7618952565 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
Practice locations: Appleton, MN; Hancock, MN
O20121217000417 MN Part A Provider - Rural Health Clinic 7618952565 Practice locations: Appleton, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730126673. Details of each certification follow.

Rural health clinic certification: CCN 243467

Legal name
APPLETON AREA HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 3, 2013
Last certification
Feb 19, 2020
Ownership / control type
2A
Organization structure
OtherNon-profit
Enrollment address
30 S Behl St
Appleton, MN 56208-1616
Related CCNs
241341

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Appleton Area Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

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
Jacob William Redepenning Individual Corporate OfficerCfo Dec 13, 2017
W-2 Managing EmployeeCfo Dec 13, 2017
Gregory Miner Individual Corporate OfficerCeo Dec 31, 2021
W-2 Managing EmployeeCeo Dec 31, 2021
Appleton Area Health Organization, Appleton, MN Non-profit Operational/Managerial Control Oct 16, 2012

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 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1730126673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S. BEHL ST.",
            "city": "APPLETON",
            "state": "MN",
            "postal_code": "56208",
            "telephone_number": "320-289-1580",
            "fax_number": "320-289-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S. BEHL ST.",
            "city": "APPLETON",
            "state": "MN",
            "postal_code": "56208",
            "telephone_number": "320-289-1580",
            "fax_number": "320-289-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLETON AREA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "REDEPENNING",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-289-8514"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, MN

Sources for this page

Verify at the official NPI Registry.