St. Joseph'S Area Health Services
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Park Rapids, MN
NPI 1740325919 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1740325919
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 335388 (MN)
- Legal business name
- ST. JOSEPH'S AREA HEALTH SERVICES
- Practice address
- 600 Pleasant Ave S
Park Rapids, MN 56470-1431 - Phone
- (218) 732-3311
- Fax
- (218) 237-5585
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Ben Koppelman
- Title
- Ceo
- Phone
- (218) 732-3311
Owners & managing parties with NPI records 1
-
Todd M Officer, MD
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 5
Related certifications (CCN) 1
Practitioners 23
-
Kristi Leigh Dreyer, D.O.
-
Christopher M Callahan, M.D.
-
Karl J Carlson, CRNA
-
Bonita Faye Conner, FNP
-
Michelle Dawn Crissinger, APRN, CNP
-
Anthony Hacker, M.D.
-
Elizabeth Hirt, PAC
-
John R Lageson, MD
-
Matthew Lee, M.D.
-
Scott Ryan Maanum, M.D.
-
Susan Victoria Ross, NP-C
-
Ryan G Strasburg, CRNA
-
Christian Sommer Vankirk, M.D.
-
John W Hoscheid, CRNA
-
Timothy J Meier, PA-C
-
Ricardy Rimpel, M.D
Affiliated clinicians 2
-
John R Lageson, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospital certification: CCN 24Z380
- Legal name
- ST. JOSEPH'S AREA HEALTH SERVICES
- Doing business as
- CHI ST JOSEPH'S HEALTH
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 19, 1945 in MN
- Enrollment address
- 600 Pleasant Ave S
Park Rapids, MN 56470-1431
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Mishai Lee |
Corporate Officer |
Nov 1, 2018 | |
| Allan Judson |
Corporate Director |
Jul 1, 2022 | |
| Commonspirit Health |
5% Or Greater Direct Ownership Interest | Jul 1, 1996 | 100% |
| Daniel Morissette |
Corporate Officer |
Feb 1, 2019 | |
| Other |
Sep 2, 2023 | ||
| Benjamin Koppelman |
Corporate Officer |
Jan 1, 2007 | |
| Other |
Jan 1, 2007 | ||
| Kurt Hansen |
Corporate Officer |
Jul 1, 2017 | |
| Todd M Officer |
Corporate Director |
Jan 1, 2022 | |
| Deborah Haagenson |
Corporate Officer |
Jul 1, 2005 | |
| Corporate Director |
Aug 1, 2022 | ||
| Jason McCollum |
Corporate Director |
Jul 1, 2022 | |
| Jay Paul Ross |
Corporate Officer |
Jan 30, 2012 | |
| W-2 Managing Employee |
Jan 30, 2012 | ||
| Clifford Tweedale |
Corporate Officer |
Jul 1, 2017 | |
| Bernice M Ebner |
Corporate Officer |
May 1, 2019 | |
| Bradley Dahn |
Corporate Officer |
Feb 5, 2019 | |
| Esther Simon |
Corporate Officer |
Feb 5, 2019 | |
| Jessica Jensen |
Corporate Director |
Aug 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120113000560 | MN | Part a Provider - Critical Access Hospital | 0345146510 |
Receives reassigned benefits from 2 practitioners Practice locations: Park Rapids, MN |
National Provider Directory
- Tax ID family
- St Josephs Area Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 335388 | MN | Yes |
Addresses
Primary practice location
600 Pleasant Ave S
Park Rapids, MN 56470-1431
Mailing address
600 Pleasant Ave S
Park Rapids, MN 56470-1431
Phone (218) 732-3311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5025417 | Other | MN | MEDICA |
| 1796HJO | Other | MN | BLUE CROSS OF MN |
| 1M141JO | Other | MN | BLUE SHIELD PROFESS FEES |
| 60394 | Other | MN | HEALTHPARTNERS |
| 1027974 | Other | MN | PREFERRED ONE |
| CE9455 | Other | MN | MEDICARE RAILROAD |
Other providers in Park Rapids, MN
- St Marys Regional Health Center
- St Marys Regional Health Center
- St. Joseph'S Area Health Services
- St. Joseph'S Area Health Services
- St. Joseph'S Area Health Services
- St. Josephs Area Health
- Allison Steffen
- Stellher Human Services, Inc.
- Mark Andrew Stenberg
- Frederick Marvin Stibbe
All providers in Park Rapids, MN · Medicare Defined Swing Bed Hospital Unit in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.