NPIMap

Organization Active NPI

Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
National Provider Identifier
1730248907
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
00336 Issued in MN
Legal business name
MINNESOTA VALLEY HEALTH CENTER INC
Practice address
621 S 4TH St
Le Sueur, MN 56058-2203
Phone
(507) 665-3375
Fax
(507) 665-2191
NPI assigned
Dec 6, 2006
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Michael Phelps
Title
President/Ceo
Phone
(952) 442-2191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 00336 MN Primary
Critical Access Hospital 282NC0060X 24Z375 MN

Addresses

Primary practice location

621 S 4TH St
Le Sueur, MN 56058-2203

Mailing address

621 S 4TH St
Le Sueur, MN 56058-2203
Phone (507) 665-3375

Other identifiers 1

IdentifierTypeStateIssuer
529245000MedicaidMN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040301000309 MN Part B Supplier - Clinic/Group Practice 9032006507 Receives reassigned benefits from 237 practitioners
1 other NPI on this enrollment
Practice locations: Le Sueur, MN
O20061104000638 MN Part A Provider - Critical Access Hospital 9032006507 Receives reassigned benefits from 15 practitioners
Practice locations: Le Sueur, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730248907. Details of each certification follow.

Hospital certification: CCN 241375

Legal name
MINNESOTA VALLEY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2005
Last certification
Mar 8, 2017
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
621 S 4TH St
Le Sueur, MN 56058-2203
Main/Primary Hospital Location

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

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
Minnesota Valley Health Center IncCCN 241375 · 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Acacia Meis Individual W-2 Managing EmployeeCredentialing Manager Jun 6, 2022
Robert Broeder Individual Corporate OfficerBoard Director Jan 1, 1995
Betty Braun Individual Corporate OfficerBoard Director Jan 1, 2026
Mark Amundson Individual Corporate OfficerBoard Director Jan 1, 2021
Christopher Bielke Individual W-2 Managing EmployeeDirector of Payer Strategy Jun 20, 2022
Kay King Individual Corporate OfficerBoard Director Jan 1, 2018
Pamela Jean Williams Individual Corporate OfficerBoard Member Jan 1, 2023
Ben C Nielsen Individual Corporate OfficerChief Operating Officer Jun 24, 2016
Michael J Phelps Individual Corporate OfficerChief Executive Officer Jun 24, 2016
Jeffrey T Nelson Individual Corporate OfficerBoard Member Jan 1, 2022
Brent K Wordelman Individual Corporate OfficerChief Financial Officer Apr 20, 2026
Aaron a Bloomquist Individual Corporate OfficerChief Financial Officer Jan 1, 2022
Ridgeview Medical Center Organization, Waconia, MN Non-profit 5% Or Greater Direct Ownership Interest Jun 24, 2016 100%

Owners & managing parties with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 246

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 246

Affiliated clinicians 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1730248907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S 4TH ST",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560582203",
            "telephone_number": "507-665-3375",
            "fax_number": "507-665-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S 4TH ST",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560582203",
            "telephone_number": "507-665-3375",
            "fax_number": "507-665-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA VALLEY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "952-442-2191"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "00336",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "24Z375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529245000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Sueur, MN

Sources for this page

Verify at the official NPI Registry.