NPIMap

Organization Active NPI

Mayo Clinic Health System-Southeast Minnesota Region

Doing business as Mayo Clinic Health System-Cannon Falls

  • Medicare Defined Swing Bed Hospital Unit
  • Cannon Falls, MN
National Provider Identifier
1790791077
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
Doing business as
Mayo Clinic Health System-Cannon Falls
Practice address
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Phone
(507) 263-6000
NPI assigned
Jul 31, 2006
Last updated
Apr 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Morris Miller
Title
Cheif Financial Officer
Phone
(507) 594-6449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

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 1

IdentifierTypeStateIssuer
OM23ECAOtherMNBC/BS

Other names 1

  • Mayo Clinic Health System-Cannon Falls Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171129002988 MN Part A Provider - Critical Access Hospital 4385556703 Practice locations: Cannon Falls, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790791077. Details of each certification follow.

Hospital certification: CCN 24Z346

Legal name
MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
Doing business as
MAYO CLINIC HEALTH SYSTEM-CANNON FALLS
Organization structure
CorporationNon-profit
Incorporated
May 29, 1981 in MN
Enrollment address
32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Wells Clinic15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Member of 1

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

  • Mayo Clinic
    • Durable Medical Equipment & Medical Supplies
    • Rochester, MN
    • NPI 1467622092

    Member Of

    NPD member

Member organizations 2

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Meggan Luevano Individual Corporate DirectorBoard Member Mar 25, 2026
Dena Keilman Individual Corporate DirectorBoard Member Jan 1, 2025
Karthik Ghosh Individual Corporate OfficerCeo, President, Chair Jan 1, 2025
Corporate DirectorBoard Member Jan 1, 2025
Travis Paul Individual Corporate OfficerSecretary & Cao Jan 1, 2025
Corporate DirectorBoard Member Jan 1, 2025
Tara Krosch Individual Corporate DirectorBoard Member Jan 1, 2025
Mansi Kanuga Individual Corporate DirectorBoard Member Jan 1, 2025
Brian Lynch Individual Corporate DirectorBoard Member Jan 1, 2025
Taylor Beahrs Individual Corporate DirectorBoard Member Jan 1, 2025
Christopher R Gulden Individual W-2 Managing EmployeeAd; Jan 1, 2021
Gokhan Anil Individual Corporate DirectorBoard Member May 10, 2023
Mayo Clinic Organization, Rochester, MN Corporation, Non-profit, Chain home office Operational/Managerial Control Jan 1, 2018
Brian Bartlett Individual Corporate DirectorBoard Member Jan 1, 2025
Bethanie Flattum Individual W-2 Managing EmployeeVice Chair Administrator Jan 1, 2021
Syed Khan Individual Corporate DirectorBoard Member Jan 1, 2025
Albert Harris Individual Corporate DirectorBoard Member Jan 1, 2025
Morris Miller Individual Corporate OfficerTreasurer & Chief Financial Officer Jul 19, 2023
Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 14

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

View all 14

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Mayo Clinic Health System-Lake CityLake City, MN, CCN 24Z338 Hospital Operational/Managerial Control Jan 1, 2019
Mayo Clinic Health System-Lake CityLake City, MN, CCN 241338 Hospital Operational/Managerial Control Jan 1, 2019

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1790791077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32021 COUNTY 24 BLVD",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550095003",
            "telephone_number": "507-263-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32021 COUNTY 24 BLVD",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550095003",
            "telephone_number": "507-263-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "CHEIF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-594-6449"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "OM23ECA",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Health System-Cannon Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cannon Falls, MN

Sources for this page

Verify at the official NPI Registry.