NPIMap

Organization Active NPI

St. Luke's Hospital of Duluth

Doing business as Aspirus St Lukes Urgent Care Hermantown

  • Family Medicine Physician
  • Hermantown, MN
National Provider Identifier
1891749594
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. LUKE'S HOSPITAL OF DULUTH
Doing business as
Aspirus St Lukes Urgent Care Hermantown
Practice address
4190 Loberg Ave
Hermantown, MN 55811-2652
Phone
(218) 249-5700
Fax
(218) 249-4666
NPI assigned
May 19, 2006
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Katherine Becker
Title
VP Compliance
Phone
(218) 249-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4190 Loberg Ave
Hermantown, MN 55811-2652

Mailing address

4190 Loberg Ave
Hermantown, MN 55811-2652
Phone (218) 249-5700

Other names 1

  • Aspirus St Lukes Urgent Care Hermantown Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031120000212 MN Part B Supplier - Clinic/Group Practice 7113834839 Receives reassigned benefits from 584 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Grand Rapids, MN; Duluth, MN; Hibbing, MN; Moose Lake, MN; Proctor, MN; Silver Bay, MN; Two Harbors, MN; Virginia, MN…
O20040323000234 WI Part B Supplier - Clinic/Group Practice 7113834839 Receives reassigned benefits from 88 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ashland, WI; Washburn, WI; Superior, WI; South Range, WI; Mellen, WI
O20050404000822 MN Part A Provider - Hospital 7113834839 25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891749594. Details of each certification follow.

Hospital certification: CCN 240047

Legal name
ST. LUKE'S HOSPITAL OF DULUTH
Doing business as
ASPIRUS ST LUKES HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 13, 1990
Beds
267
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
915 E 1St St
Duluth, MN 55805-2107
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

Other NPIs on the same Medicare enrollment 32

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

View all 32

Care Compare: Hospital

Medicare Care Compare
Listed as
St Lukes HospitalCCN 240047 · All quality measures
Overall star rating
3 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

Locations

1001 E Superior St
#L201
Duluth, MN 55802
Phone (218) 249-3057

4190 Loberg Ave
Hermantown, MN 55811
Phone (218) 249-4600

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Scott Allen Lyons Individual Corporate OfficerBoard Member Oct 1, 2023
Kiera Marie Wilson Individual Corporate OfficerBoard Member Oct 1, 2023
Mitchell Lynn Cardwell Individual Corporate OfficerBoard Member Oct 1, 2020
Maurine Helen Settergren Individual Corporate OfficerBoard Member Oct 1, 2020
Helena Everett Jackson Individual Corporate OfficerBoard Member Oct 1, 2023
Aspirus, Inc Organization, Wausau, WI Corporation, Non-profit, Chain home office Operational/Managerial Control Mar 1, 2024 100%
Anna Christine Sackette-Urness Individual Corporate OfficerBoard Member Jun 1, 2022
James Matheson Individual Corporate OfficerBoard Member Mar 1, 2024
Jack Herman Seiler Individual Corporate OfficerBoard Member Oct 1, 2022
Nicholas J Van Deelen Individual Corporate DirectorPresident Jan 16, 2019
Aimee Nelson Vanstraaten Individual Corporate DirectorBoard of Directors Feb 29, 2016
Lori Peck Individual W-2 Managing EmployeeVP - System Finance Mar 1, 2024
Tyler Hack Individual W-2 Managing EmployeeVP - System Revenue Cycle Mar 1, 2024
Matthew F Heywood Individual W-2 Managing Employee Mar 1, 2024
Yvonne Marie Solon Individual Corporate DirectorBoard of Directors Apr 27, 2015

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 29

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 29

Affiliated clinicians 657

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

View all 657

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1891749594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 LOBERG AVE",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112652",
            "telephone_number": "218-249-5700",
            "fax_number": "218-249-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S HOSPITAL OF DULUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "VP COMPLIANCE",
        "authorized_official_telephone_number": "218-249-5555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspirus St Lukes Urgent Care Hermantown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.