Mayo Clinic Health System-Southeast Minnesota Region
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Cannon Falls, MN
NPI 1790791077 · NPPES record last updated Apr 16, 2026
Key facts
- NPI
- 1790791077
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- Legal business name
- MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
- Practice address
- 32021 County 24 Blvd
Cannon Falls, MN 55009-5003 - Phone
- (507) 263-6000
- NPI assigned
- Jul 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Morris Miller
- Title
- Cheif Financial Officer
- Phone
- (507) 594-6449
Owners & managing parties with NPI records 14
-
Gokhan Anil, MD
-
Brian N Bartlett, MD
-
Taylor R Beahrs, MD
-
Karthik Ghosh, M.D.
-
Albert R Harris, M.D.
-
Mansi Jayesh Kanuga, M.D,
-
Syed Anjum Khan, MD
-
Tara C.K. Krosch, MD
-
Brian A Lynch, MD
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 14
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 38
Practitioners 550
-
Shada Ahrar, MD
-
Timothy R Aksamit, M.D.
-
Robert C Albright Jr., D.O.
-
Jonathan D Alleckson, CRNA
-
Megan Alm, PA
-
Nandan S Anavekar, MBBCH
-
Nicole Kathryn Anderson, CRNA
-
Trent D Anderson, D.O.
-
Dimitra Andreadaki, PA-C
-
Gokhan Anil, MD
-
Samuel J Asirvatham, M.D.
-
John W Askew III, M.D.
-
Ivor Asztalos, MD
-
Ross Anthony Avant, M.D.
Affiliated clinicians 4
-
Anne Enanga Liwonjo, M.D
-
Thomas W Nordahl, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Hospital certification: CCN 24Z346
- Legal name
- MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
- Doing business as
- MAYO CLINIC HEALTH SYSTEM-CANNON FALLS
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 29, 1981 in MN
- Enrollment address
- 32021 County 24 Blvd
Cannon Falls, MN 55009-5003
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Meggan Luevano |
Corporate Director |
Mar 25, 2026 | |
| Dena Keilman |
Corporate Director |
Jan 1, 2025 | |
| Karthik Ghosh |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Jan 1, 2025 | ||
| Travis Paul |
Corporate Officer |
Jan 1, 2025 | |
| Corporate Director |
Jan 1, 2025 | ||
| Tara Krosch |
Corporate Director |
Jan 1, 2025 | |
| Mansi Kanuga |
Corporate Director |
Jan 1, 2025 | |
| Brian Lynch |
Corporate Director |
Jan 1, 2025 | |
| Taylor Beahrs |
Corporate Director |
Jan 1, 2025 | |
| Christopher R Gulden |
W-2 Managing Employee |
Jan 1, 2021 | |
| Gokhan Anil |
Corporate Director |
May 10, 2023 | |
| Mayo Clinic |
Operational/Managerial Control | Jan 1, 2018 | |
| Brian Bartlett |
Corporate Director |
Jan 1, 2025 | |
| Bethanie Flattum |
W-2 Managing Employee |
Jan 1, 2021 | |
| Syed Khan |
Corporate Director |
Jan 1, 2025 | |
| Albert Harris |
Corporate Director |
Jan 1, 2025 | |
| Morris Miller |
Corporate Officer |
Jul 19, 2023 | |
| Corporate Director |
Jan 1, 2025 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Mayo Clinic Health System-Lake City |
Hospital | Operational/Managerial Control | Jan 1, 2019 |
| Mayo Clinic Health System-Lake City |
Hospital | Operational/Managerial Control | Jan 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171129002988 | MN | Part a Provider - Critical Access Hospital | 4385556703 | Practice locations: Cannon Falls, MN |
National Provider Directory
- Tax ID family
- Kiester Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Yes |
Addresses
Primary practice location
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Mailing address
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Phone (507) 263-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OM23ECA | Other | MN | BC/BS |
Other names
- Mayo Clinic Health System-Cannon Falls
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Cannon Falls, MN
- Matthew August Maki
- Mayo Clinic Health System-Southeast Minnesota Region
- Mayo Clinic Health System-Southeast Minnesota Region
- Mayo Clinic Health System-Southeast Minnesota Region
- Mayo Clinic Health System-Southeast Minnesota Region
- Mayo Foundation for Medical Education & Research
- Amy Lee McAlister
- McIntee Chiropractic Clinic
- Patrick James McIntee
- Kala Marie Moline
All providers in Cannon Falls, 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 16, 2026. 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.