NPIMap

Organization Active NPI

Aitkin Community Hospital, Inc.

Doing business as Riverwood Healthcare Center

  • Rural Health Clinic/Center
  • Aitkin, MN
National Provider Identifier
1902960875
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
AITKIN COMMUNITY HOSPITAL, INC.
Doing business as
Riverwood Healthcare Center
Practice address
200 Bunker Hill Dr
Aitkin, MN 56431
Phone
(218) 927-2157
Fax
(218) 927-4130
NPI assigned
Dec 21, 2006
Last updated
Feb 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
Kenneth A Westman
Title
Ceo
Phone
(218) 927-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

200 Bunker Hill Dr
Aitkin, MN 56431

Mailing address

200 Bunker Hill Dr
Aitkin, MN 56431-1865
Phone (218) 927-2157

Other identifiers 4

IdentifierTypeStateIssuer
39A31RIOtherBLUE CROSS
105805OtherMNUCARE
848136900MedicaidMN
47305OtherHEALTH PARTNERS

Other names 1

  • Riverwood Healthcare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000544 MN Part A Provider - Rural Health Clinic 4981514692 Practice locations: Aitkin, MN
O20031107000093 MN Part B Supplier - Clinic/Group Practice 4981514692 Receives reassigned benefits from 185 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aitkin, MN; Garrison, MN; McGregor, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902960875. Details of each certification follow.

Rural health clinic certification: CCN 243406

Legal name
AITKIN COMMUNITY HOSPITAL INC
Doing business as
RIVERWOOD HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 21, 1996
Last certification
Aug 2, 2012
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1948 in MN
Enrollment address
200 Bunker Hill Dr
Aitkin, MN 56431-1865

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Lowell Larson Individual Corporate DirectorGoverning Board Member Oct 9, 2019
Heather Hipp Individual Corporate DirectorGoverning Board Member Jun 14, 2023
Chad Gross Individual Corporate Director Jan 9, 2013
David Douglas Taylor Individual Corporate OfficerChief Medical Officer Dec 17, 2018
Casey Johnson Individual Corporate OfficerCfo Jun 16, 2014
Jared Lundgren Individual Corporate Director Jan 2, 2012
Steven Wilson Individual Corporate Director Nov 19, 2007
Cindi Baker Individual Corporate Officer Apr 2, 2001
Corporate Director Apr 2, 2016
Christine Bright Marwede Individual Corporate DirectorGoverning Board Member Apr 6, 2015
Kathleen M Ryan Individual Corporate Director Dec 2, 2013
Carla Zubko Individual Corporate OfficerChief Nursing Officer Aug 1, 2021
Kenneth a Westman Individual Corporate OfficerChief Executive Officer Feb 14, 2022
W-2 Managing EmployeeChief Executive Officer Feb 14, 2022 100%
Michael Paulbeck Individual Corporate DirectorBoard Member Nov 29, 2010
Jeffrey G Ehnstrom Individual Corporate DirectorGoverning Board Member Nov 19, 2007
Wendy M Franke Individual Corporate OfficerChief Quality Officer Jan 10, 2022
Lee Reichenbach Individual Corporate OfficerChief Human Resource Officer Feb 10, 2022
Timothy G Dirks Individual Corporate DirectorGoverning Board Member Jul 1, 2013
Thomas Lundberg Individual Corporate Director Nov 27, 2012

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 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1902960875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BUNKER HILL DR",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "564311865",
            "telephone_number": "218-927-2157",
            "fax_number": "218-927-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BUNKER HILL DR",
            "city": "AITKIN",
            "state": "MN",
            "postal_code": "56431",
            "telephone_number": "218-927-2157",
            "fax_number": "218-927-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AITKIN COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "WESTMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-927-5501"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "39A31RI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "105805",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "848136900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "47305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwood Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverwood Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aitkin, MN

Sources for this page

Verify at the official NPI Registry.