Tweeten Lutheran Healthcare Center, Inc
Organization Active NPI Skilled Nursing Facility · Spring Grove, MN
NPI 1891876181 · NPPES record last updated May 1, 2013
Key facts
- NPI
- 1891876181
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 332995 (MN)
- Legal business name
- TWEETEN LUTHERAN HEALTHCARE CENTER, INC
- Practice address
- 125 5TH Ave SE
Spring Grove, MN 55974-1318 - Phone
- (507) 498-3211
- Fax
- (507) 498-3228
- NPI assigned
- Oct 17, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- GUNDERSEN LUTHERAN HEALTH SYSTEMS, INC
Authorized official
- Name
- Tim Samuelson
- Title
- Ceo
- Phone
- (507) 498-3211
Owners & managing parties with NPI records 1
-
Randi Kirsten Berg, M.D.
Facilities with the same owner 49
Practitioners 1
-
Randi Kirsten Berg, M.D.
Affiliated clinicians 1
-
Randi Kirsten Berg, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Tweeten Lutheran Health Care Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Feb 1, 1987
- Medicare certification status
- Active
- Certified beds
- 49 · 35.6 residents per day on average
- Special focus status
- SFF Candidate
- Penalties (3 years)
- 1 · fines totaling $0
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D1019586 | Tweeten Lutheran Healthcare Center, Inc | Certificate of waiver | Nov 20, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245429
- Legal name
- TWEETEN LUTHERAN HEALTHCARE CENTER, INC
- Doing business as
- GUNDERSEN TWEETEN CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1987
- Last certification
- Jan 9, 2025
- Beds
- 49
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Emplify Health System (Gundersen)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 125 5TH Ave SE
Spring Grove, MN 55974-1318 - Nursing home name
- TWEETEN LUTHERAN HEALTH CARE CENTER
All disclosed owners & managing parties 41
| Name | Role | Since | Share |
|---|---|---|---|
| Charles P Ness |
Operational/Managerial Control | Aug 1, 2025 | |
| Adp of the SNF | Mar 3, 2026 | ||
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Sue Spinden |
Operational/Managerial Control | Jan 1, 2025 | |
| |
Adp of the SNF | Jun 9, 2025 | |
| Karen L Foster |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| |
Adp of the SNF | Sep 30, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Renee Walton |
Operational/Managerial Control | Jan 1, 2025 | |
| Randi K Berg |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Apr 11, 2025 | ||
| Tracer Rankin |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Brenda S Moser |
Corporate Officer |
Jan 1, 2025 | |
| Adp of the SNF | Feb 1, 2017 | ||
| |
Adp of the SNF | Jan 1, 2025 | |
| Bellin Gundersen Health System Inc |
5% Or Greater Indirect Ownership Interest | Nov 30, 2022 | 100% |
| Operational/Managerial Control | Nov 30, 2022 | 100% | |
| Timothy Dewall |
Operational/Managerial Control | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Kraig Schuster |
Corporate Officer |
Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Amanda Pericak |
Corporate Director |
Apr 1, 2022 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Lindsey Ranzenberger |
Operational/Managerial Control | Jan 1, 2025 | |
| Sarah Melde |
Corporate Director |
Jan 1, 2024 | |
| Elizabeth Hermeier |
Corporate Director |
Jan 1, 2024 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Amy Heaney |
Adp of the SNF | Jan 1, 2025 | |
| Gundersen Lutheran Health System Inc |
5% Or Greater Direct Ownership Interest | Aug 22, 1986 | 100% |
| Operational/Managerial Control | Aug 22, 1986 | 100% | |
| Vickie M Bakalars |
Corporate Director |
Feb 1, 2017 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Jane Morken |
Corporate Director |
Feb 1, 2022 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Charles L Johnson |
Corporate Director |
Jan 23, 2019 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| Bruce Hegge |
Corporate Director |
Feb 1, 2022 | |
| |
Adp of the SNF | Sep 19, 2025 | |
| Kari B Adank |
Corporate Officer |
Feb 21, 2024 | |
| Mark Branum |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040818000874 | MN | Part a Provider - Skilled Nursing Facility | 5698748507 | Practice locations: Spring Grove, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 332995 | MN | Yes |
Addresses
Primary practice location
125 5TH Ave SE
Spring Grove, MN 55974-1318
Mailing address
125 5TH Ave SE
Spring Grove, MN 55974-1318
Phone (507) 498-3211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068252700 | Medicaid | MN | |
| 1D30TW | Other | MN | BLUE CROSS BLUE SHIELD MN |
Other names
- Gundersen Tweeten Care Center
Other providers in Spring Grove, MN
- Spring Grove Assisted Living LLC
- Spring Grove Family Chiropractic, PA
- The Reflective Haven LLC
- Molly E Thomas
- Gregory N Tjossem
All providers in Spring Grove, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2013. 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.