Pine Haven Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

334206 Issued in MN

Legal business name

PINE HAVEN INC

Practice address

210 3Rd St NW
Pine Island, MN 55963-9139

Phone

(507) 356-8304

Fax

(507) 356-4400

NPI assigned

Mar 5, 2007

Last updated

Jun 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steve R Ziller

Title

Administrator / Ceo

Phone

(507) 356-8304

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962531012. Details of each certification follow.

• CCN 245359 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245359

Legal name

PINE HAVEN INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 1, 1986

Last certification

Jul 17, 2024

Beds

70

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 1, 1968 in MN

Enrollment address

210 3Rd NWST
Pine Island, MN 55963-9139

Listed as

Edenbrook Pine HavenCCN 245359 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Nov 1, 1986

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7056.4 residents per day on average

Penalties (3 years)

1Fines totaling $14,898

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

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

Practitioners 2

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.

• Kathryn Jo Chamberlain, MD

  • Family Medicine Physician
  • Pine Island, MN
  • NPI 1033606710
  NPD (past)
• Kyle M McKenzie, MD

  • Internal Medicine Physician
  • Rochester, MN
  • NPI 1942595012
  NPD (past)

Affiliated clinicians 4

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

• Matthew Francis Howard Beeson, MD

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1639457419

  Nursing home

  Care Compare affiliation
• Kathryn Jo Chamberlain, MD

  • Family Medicine Physician
  • Pine Island, MN
  • NPI 1033606710

  Nursing home

  Care Compare affiliation
• Hillary Moen Fitzgerald, MD

  • Family Medicine Physician
  • Rochester, MN
  • NPI 1538522297

  Nursing home

  Care Compare affiliation
• Kyle M McKenzie, MD

  • Internal Medicine Physician
  • Rochester, MN
  • NPI 1942595012

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1962531012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 3RD ST NW",
            "city": "PINE ISLAND",
            "state": "MN",
            "postal_code": "55963",
            "telephone_number": "507-356-8304",
            "fax_number": "507-356-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 3RD ST NW",
            "city": "PINE ISLAND",
            "state": "MN",
            "postal_code": "559639139",
            "telephone_number": "507-356-8304",
            "fax_number": "507-356-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "ZILLER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR / CEO",
        "authorized_official_telephone_number": "507-356-8304"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "334206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "664240300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "245359",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8791PI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Joel Meints, D.C.
• National Birth Centers, Inc.
• Kelsie Nelson
• Lab Nika
• Omc Retail Services LLC (Olmsted Medical Center Pine Island Pharmacy)
• Pine Island Dental LLC
• Pine Island Operations LLC
• Kristine Rita Prescher-Meints, D.C.
• Private Healthcare Facilities
• Renewed Perspectives LLC

• Skilled Nursing Facility in Pine Island, MN
• Providers in Pine Island, 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 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.