NPIMap

Organization Active NPI

Perham Hospital District

  • Critical Access Hospital
  • Perham, MN
National Provider Identifier
1790799518
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
PERHAM HOSPITAL DISTRICT
Practice address
1000 Coney St W
Perham, MN 56573-2102
Phone
(218) 347-4500
Fax
(218) 346-4540
NPI assigned
Jul 28, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Justine Anderson
Title
VP of Finance
Phone
(218) 347-1306

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 4

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

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

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 83

Affiliated clinicians 255

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

View all 255

Care Compare: Hospital

Medicare Care Compare
Listed as
Perham HealthCCN 241373
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000612 MN Part a Provider - Critical Access Hospital 2264327766 Receives reassigned benefits from 70 practitioners
1 other NPI on this enrollment
Practice locations: Perham, MN

Hospital certification: CCN 241373

Medicare enrollment files
Legal name
PERHAM HOSPITAL DISTRICT
Doing business as
PERHAM HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2005
Last certification
Nov 5, 2015
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
1000 Coney St W
Perham, MN 56573-2102

All disclosed owners & managing parties 17

Medicare enrollment files

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

NameRoleSinceShare
Thomas P Meyer Individual Corporate DirectorBoard Member Jan 1, 2015
William Stoderl Individual Corporate OfficerCfo Jan 1, 2025
W-2 Managing EmployeeAd; Jun 25, 2018
Jared Bachelder Individual Corporate DirectorBoard Member Feb 15, 2025
Michael Brasel Individual Corporate Director Jun 27, 2018
Eugene Jahnke Individual Corporate Director Feb 1, 2010
Cynthia Rastedt Individual Corporate Director Oct 17, 2007
Sue Huebsch Individual Corporate Director Jan 1, 2024
Alana Vanwatermulen Individual Corporate Director Sep 26, 2018
Spencer Schram Individual Corporate Director Dec 1, 2017
Allan L Berube Individual Corporate Director Jan 31, 2017
Richard Richter Individual Corporate Director Oct 17, 2007
Erika Altstadt Individual W-2 Managing EmployeeExecutive Assistant Oct 24, 2018
Arvin Widness Individual Corporate DirectorBoard Member Jan 1, 2025
Michael Lee Individual Corporate DirectorBoard Member Jan 1, 2025
Alisyn Keil Individual Corporate Director Oct 17, 2007
Terry Marthaler Individual Corporate Director Feb 1, 2010
Charles Hofius Individual Contracted Managing EmployeeCeo Oct 17, 2007
Corporate OfficerCeo Oct 17, 2007

All facility ownership & control disclosures 1

Medicare enrollment files

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

FacilityTypeRoleSince
Perham Living Home CarePerham, MN, CCN 248060 Home health agency Operational/Managerial Control Jul 16, 1998

National Provider Directory

National Provider Directory
Tax ID family
Perham Hospital District7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

NPPES NPI Registry

Primary practice location

1000 Coney St W
Perham, MN 56573-2102

Mailing address

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-4500

Other identifiers 7

NPPES NPI Registry
IdentifierTypeStateIssuer
211047400MedicaidMN
1006086OtherMNPREFERRED ONE
300416OtherMNUCARE OF MN
103925OtherMNCHOICE PLUS
5017663OtherMNMEDICA
1741OtherMNHEALTH PARTNERS
1808HMEOtherMNBLUE CROSS

Other names 1

NPPES NPI Registry
  • Perham Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 24, 2018.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1790799518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-4500",
            "fax_number": "218-346-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-4500",
            "fax_number": "218-346-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERHAM HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "218-347-1306",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211047400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1006086",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE OF MN",
            "identifier": "300416",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE PLUS",
            "identifier": "103925",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5017663",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "1741",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1808HME",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perham Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perham Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.