Riverview Healthcare Association
Organization Active NPI Multi-Specialty Clinic/Center · East Grand Forks, MN
NPI 1811918436 · NPPES record last updated Jan 22, 2019
Key facts
- NPI
- 1811918436
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Ms. Betty J Arvidson
- Title
- Cfo
- Phone
- (218) 281-9756
Owners & managing parties with NPI records 2
-
Erik J Kanten, MD
-
Brett K Vibeto, MD
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 4
Practitioners 96
-
Jennifer B Dotseth, MSN, APRN, PMHNP-BC
-
Jeremy Joseph Eversvik, CRNA
-
Ian Glidden, MD
-
Tia Michelle Gullickson, FNP-C
-
Riley Hermreck, FNP-C
-
Nicole Johnson, NP
-
Brent Allen Kaiser, CRNA
-
Erik J Kanten, MD
-
Sunny S Kim, M.D.
-
Forrest Laporte, CNP
-
Israel Mostafa, MD
-
Ram Prasad Paneru, M.D.
-
Vinita J Parikh, MD
-
Steven Llewellyn Poissant, PT.,L., AC.,C.S.C.S
-
Hannah Sue Reski, PA-C
-
Lauren Rose, DO
-
Natalie Rebecca Royal, FNP-C
-
Sarah Joy Rudnik, FNP-C
Affiliated clinicians 137
-
Paul C Allegra, MD
-
Norman Arslanlar, DO
-
Aura Azarcon, MD
-
Mirza Basit Baig, MD
-
Rose BN Brandt, MD
-
Carrie Beth Clauson, PHD
-
Jennifer B Dotseth, MSN, APRN, PMHNP-BC
-
Anthony Duncan, DO
-
Jeremy Joseph Eversvik, CRNA
-
Ian Glidden, MD
-
Tia Michelle Gullickson, FNP-C
-
Douglass S. Hassell, M.D.
-
Riley Hermreck, FNP-C
-
Stephen H Hite, M.D.
-
Thomas Jerry Ibach, M.D.
-
Kayleen Jahangir, MD
-
Nicole Johnson, NP
-
Brent Allen Kaiser, CRNA
Medicare Care Compare: Hospital
- Listed as
- Riverview Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
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
- Corporation · Non-profit
- Incorporated
- Jun 14, 1898 in MN
- Enrollment address
- 323 S Minnesota St
Crookston, MN 56716-1601
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Lori Keller |
Corporate Director |
Jul 30, 2020 | |
| Christopher Patrick Bruggeman |
Corporate Officer |
Sep 1, 2007 | |
| W-2 Managing Employee |
Sep 1, 2007 | ||
| Erik J Kanten |
Corporate Director |
Jan 28, 2019 | |
| W-2 Managing Employee |
Jan 28, 2019 | ||
| Judy Hulst |
Corporate Director |
Jan 1, 2025 | |
| Brett K Vibeto |
Corporate Director |
Oct 31, 2019 | |
| W-2 Managing Employee |
Oct 31, 2019 | ||
| Tim James Brinkman |
Corporate Director |
Jan 22, 2018 | |
| Carrie a Michalski |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee |
Jan 1, 2012 | ||
| Kari Koenig |
Corporate Director |
Jan 28, 2019 | |
| Nicole Heldstab |
Corporate Director |
Jan 1, 2025 | |
| Andrew S Oman |
Corporate Director |
Jan 26, 2026 | |
| Michelle M Fairman Cote |
Corporate Director |
Jan 1, 2025 | |
| Tanner Holten |
Corporate Director |
Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5548 | Other | ND | BCBS |
| 12898 | Medicaid | ND | |
| 244T9RI | Other | MN | BCBS |
| 973488300 | Medicaid | MN |
Other providers in East Grand Forks, MN
- Andrew Reiter
- Christlie A Rene
- Ashlee Richards
- Riverview Healthcare Association
- Riverview Healthcare Association
- Juan Rosales Jr.
- Jocelyn Rozeveld
- Saeed Amin Saeed
- Sanford Clinic North
- Sanford Clinic North
All providers in East Grand Forks, MN · Multi-Specialty Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2019. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.