NPIMap

Organization Active NPI

Riverview Healthcare Association

  • Multi-Specialty Clinic/Center
  • East Grand Forks, MN
National Provider Identifier
1811918436
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RIVERVIEW HEALTHCARE ASSOCIATION
Practice address
1428 Central Ave NE
East Grand Forks, MN 56721-1605
Phone
(218) 773-1390
Fax
(218) 773-1762
NPI assigned
Jul 21, 2006
Last updated
Jan 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Ms. Betty J Arvidson
Title
Cfo
Phone
(218) 281-9756

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1428 Central Ave NE
East Grand Forks, MN 56721-1605

Mailing address

323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200

Other identifiers 4

IdentifierTypeStateIssuer
973488300MedicaidMN
5548OtherNDBCBS
12898MedicaidND
244T9RIOtherMNBCBS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040128000040 MN Part B Supplier - Clinic/Group Practice 7810806718 Receives reassigned benefits from 69 practitioners
7 other NPIs on this enrollment
Practice locations: Thief River Falls, MN; Red Lake Falls, MN; East Grand Forks, MN; Crookston, MN; Fertile, MN
O20060505000925 MN Part A Provider - Critical Access Hospital 7810806718 Receives reassigned benefits from 62 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fertile, MN; Thief River Falls, MN; Red Lake Falls, MN; Crookston, MN; East Grand Forks, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811918436. Details of each certification follow.

Hospital certification: CCN 241320

Legal name
RIVERVIEW HEALTHCARE ASSOCIATION
Doing business as
RIVERVIEW HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2001
Last certification
Aug 17, 2010
Beds
49 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 14, 1898 in MN
Enrollment address
323 S Minnesota St
Crookston, MN 56716-1601

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Riverview HospitalCCN 241320 · 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

Locations

105 International Dr
Rl Falls, MN 56750
Phone (218) 253-3480

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Lori Keller Individual Corporate DirectorBoard Member Jul 30, 2020
Christopher Patrick Bruggeman Individual Corporate OfficerC.O.O. Sep 1, 2007
W-2 Managing EmployeeAd; Sep 1, 2007
Erik J Kanten Individual Corporate DirectorBoard Member Jan 28, 2019
W-2 Managing EmployeeBoard Memeber Jan 28, 2019
Judy Hulst Individual Corporate DirectorBoard Member Jan 1, 2025
Brett K Vibeto Individual Corporate DirectorBoard Member Oct 31, 2019
W-2 Managing EmployeeBoard Memeber Oct 31, 2019
Tim James Brinkman Individual Corporate DirectorBoard Member Jan 22, 2018
Carrie a Michalski Individual Corporate OfficerC.E.O. Jan 1, 2012
W-2 Managing EmployeeAd; Jan 1, 2012
Kari Koenig Individual Corporate DirectorBoard Member Jan 28, 2019
Nicole Heldstab Individual Corporate DirectorBoard Member Jan 1, 2025
Andrew S Oman Individual Corporate DirectorBoard Member Jan 26, 2026
Michelle M Fairman Cote Individual Corporate DirectorBoard Member Jan 1, 2025
Tanner Holten Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 95

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 95

Affiliated clinicians 137

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

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1811918436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200",
            "fax_number": "218-281-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 CENTRAL AVE NE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211605",
            "telephone_number": "218-773-1390",
            "fax_number": "218-773-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERVIEW HEALTHCARE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "ARVIDSON",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-281-9756",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "973488300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5548",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12898",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "244T9RI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Grand Forks, MN

Sources for this page

Verify at the official NPI Registry.