Paynesville Area Hospital District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

330600 Issued in MN

Legal business name

PAYNESVILLE AREA HOSPITAL DISTRICT

Doing business as

KORONIS MANOR

Practice address

200 W 1St St
Paynesville, MN 56362-1445

Phone

(320) 243-3767

Fax

(320) 243-7519

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Greg Wilson

Title

Cfo/Coo

Phone

(320) 243-3767

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• KORONIS MANOR Doing business as

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1912965260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767",
            "fax_number": "320-243-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621445",
            "telephone_number": "320-243-3767",
            "fax_number": "320-243-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNESVILLE AREA HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "320-243-3767"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "330600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510675300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3L41PA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "03072202706",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KORONIS MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Woojong Park, PHARMD
• Paynesville Area Hospital District
• Paynesville Area Hospital District
• Paynesville Area Hospital District
• Paynesville Area Hospital District
• Paynesville Area Living at Home Block Nurse Program
• Paynesville Chiropractic Clinic, P.a.
• Paynesville Family Dental
• Pedi-Care, Inc
• Jane Marie Peterson, MD

• Skilled Nursing Facility in Paynesville, MN
• Providers in Paynesville, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.