NPIMap

Organization Active NPI

Centracare Health System-NR LLC

Doing business as CentraCare Health - Monticello Rehab Unit

  • Rehabilitation Hospital Unit
  • Monticello, MN
National Provider Identifier
1821337148
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
CENTRACARE HEALTH SYSTEM-NR LLC
Doing business as
CentraCare Health - Monticello Rehab Unit
Practice address
1013 Hart Blvd
Monticello, MN 55362-8575
Phone
(763) 271-2306
Fax
(763) 271-2421
NPI assigned
Feb 6, 2013
Last updated
Jun 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Mr. Gregory R Klugherz
Title
Vice President and Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

1013 Hart Blvd
Monticello, MN 55362-8575

Mailing address

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 271-2306

Other names 1

  • CentraCare Health - Monticello Rehab Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130515000683 MN Part B Supplier - Clinic/Group Practice 3870739410 Receives reassigned benefits from 320 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, MN

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 79

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 79

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1821337148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "763-271-2306",
            "fax_number": "763-271-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628575",
            "telephone_number": "763-271-2306",
            "fax_number": "763-271-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE HEALTH SYSTEM-NR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "KLUGHERZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "320-255-5665",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Health - Monticello Rehab Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.