NPIMap

Organization Active NPI

Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
National Provider Identifier
1821066499
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
330764 Issued in MN
Legal business name
MAYO CLINIC HEALTH SYSTEM-FAIRMONT
Practice address
800 Medical Center Dr
Fairmont, MN 56031-4575
Phone
(507) 238-8100
NPI assigned
Mar 9, 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
Cfo
Phone
(507) 594-6449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 330764 MN Primary

Addresses

Primary practice location

800 Medical Center Dr
Fairmont, MN 56031-4575

Mailing address

800 Medical Center Dr
Fairmont, MN 56031-4575
Phone (507) 238-8100

Other identifiers 1

IdentifierTypeStateIssuer
1628HFAOtherMNBLUE CROSS BLUE SHIELD

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
O20050412000899 MN Part A Provider - Hospital 4981694981 Practice locations: Fairmont, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821066499. Details of each certification follow.

Hospital certification: CCN 240166

Legal name
MAYO CLINIC HEALTH SYSTEM-FAIRMONT
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 5, 2013
Beds
57
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 18, 1940 in MN
Enrollment address
800 Medical Center Dr
Fairmont, MN 56031-4575
Main/Primary Hospital Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mayo Clinic Health System - FairmontCCN 240166 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Mayo Clinic Fairmont3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Timothy B Slama Individual Corporate OfficerVice Chair Jun 1, 2023
Corporate DirectorBoard Member Jun 1, 2023
Okechukwu N Osuebi Individual Corporate DirectorBoard Member Jan 1, 2024
Judy Traetow Individual Corporate DirectorBoard Member Jan 1, 2021
Karthik Ghosh Individual Corporate OfficerCeo, President, Chair Jan 6, 2025
Corporate DirectorBoard Member Jan 6, 2025
Travis Paul Individual Corporate OfficerCao,Secretary,Treasurer Nov 1, 2021
Corporate DirectorBoard Member Nov 1, 2021
W-2 Managing EmployeeAd; Jan 1, 2025
Mayo Clinic Health System-Southwest Minnesota Region Organization, Mankato, MN Corporation, Non-profit, Chain home office Operational/Managerial Control May 23, 2011
Chera Lynn Sevcik Individual Corporate DirectorBoard Member Jan 1, 2023
Mayo Clinic Organization, Rochester, MN Non-profit Operational/Managerial Control Jan 1, 2015
Morris Miller Individual Corporate OfficerAssistant Treasurer & Cfo Aug 1, 2023
Christopher Howard Hasse Individual Corporate OfficerAssistant Secretary Jul 27, 2022

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

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

Practitioners 31

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 31

Affiliated clinicians 275

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

View all 275

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1821066499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MEDICAL CENTER DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314575",
            "telephone_number": "507-238-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-FAIRMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "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": "CFO",
        "authorized_official_telephone_number": "507-594-6449"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "330764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1628HFA",
            "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": []
}

Other providers in Fairmont, MN

Sources for this page

Verify at the official NPI Registry.