Glencoe Regional Health Services
Organization Active NPI Skilled Nursing Facility · Glencoe, MN
NPI 1972610079 · NPPES record last updated Sep 13, 2018
Key facts
- NPI
- 1972610079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 329988 (MN)
- Legal business name
- GLENCOE REGIONAL HEALTH SERVICES
- Practice address
- 1805 Hennepin Ave N
Glencoe, MN 55336-1416 - Phone
- (320) 864-7790
- Fax
- (320) 864-7896
- NPI assigned
- Aug 24, 2006
- Organization subpart
- No
Authorized official
- Name
- John Doidge
- Title
- VP/Finance
- Phone
- (320) 864-7753
Owners & managing parties with NPI records 4
-
Bryan James Fritsch, D.O.
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 3
Member organizations 2
Practitioners 45
-
Bryan James Fritsch, D.O.
-
Mackenzie Rae Lobitz, M. D.
-
Nina Kristine Appleby, D.O.
-
Logan Becker, CRNA
-
Joseph Dundee, M.D.
-
Pamela Jean Ellis, APRN,CRNA
-
Abby Marie Evans, CNP
-
Terese Marie Haasken, PA-C
-
Melissa Katusky Lor, CNP
-
Benjamin Jed Knick, CRNA
-
Kari N Knodel-Vettel, MPAS PAC
-
Michael Arlin Long, P.A.-C.
-
Nicole Nash, DNP, APRN, CRNA
-
Laura Jean Olson, MD
Affiliated clinicians 8
-
Nina Kristine Appleby, D.O.
-
Bryan James Fritsch, D.O.
-
Mackenzie Rae Lobitz, M. D.
-
Laura Jean Olson, MD
Medicare Care Compare: Nursing home
- Listed as
- Glenfields Living With Care
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 26, 1983
- Medicare certification status
- Active
- Certified beds
- 108 · 95.4 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245263
- Legal name
- GLENCOE REGIONAL HEALTH SERVICES
- Doing business as
- GLENFIELDS LIVING WITH CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 26, 1983
- Last certification
- Jun 5, 2025
- Beds
- 108
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2015 Hennepin Ave N
Glencoe, MN 55336-1446 - Nursing home name
- GLENFIELDS LIVING WITH CARE
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Angela Erickson |
Corporate Officer |
Feb 9, 2019 | |
| W-2 Managing Employee |
Feb 19, 2019 | ||
| Adp of the SNF | Dec 19, 2024 | ||
| Bryan T Petersen |
Corporate Director | Jul 11, 2011 | |
| W-2 Managing Employee |
Jul 11, 2011 | ||
| Adp of the SNF | Dec 19, 2024 | ||
| Kristine L Knudten |
Corporate Officer |
Nov 5, 2018 | |
| W-2 Managing Employee |
Nov 5, 2018 | ||
| Benjamin Davis |
Corporate Officer |
May 15, 2023 | |
| W-2 Managing Employee |
May 15, 2023 | ||
| Kristen L Budahn |
Corporate Director |
Jan 1, 2024 | |
| Jill M Hatlestad |
W-2 Managing Employee | Nov 16, 2007 | |
| Heather Peirce |
Corporate Director | Jan 1, 2021 | |
| Julie a Schmidt |
W-2 Managing Employee |
Nov 16, 2007 | |
| Adp of the SNF | Dec 19, 2024 | ||
| Sean David Tritabaugh |
Corporate Director | Jan 1, 2024 | |
| Scott Kuehn |
Corporate Director | Jan 1, 2017 | |
| Mary K Stoltenburg |
Corporate Director | Jan 1, 2018 | |
| Lynn Kathryn Beranek |
W-2 Managing Employee | Sep 4, 2023 | |
| Bryan J Fritsch |
Corporate Director | Jan 1, 2016 | |
| Melea R Anderson |
W-2 Managing Employee |
Mar 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080505000752 | MN | Part a Provider - Skilled Nursing Facility | 1759292980 | Practice locations: Glencoe, MN |
National Provider Directory
- Tax ID family
- Glencoe Regional HLTH
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 329988 | MN | Yes |
Addresses
Primary practice location
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Mailing address
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-7790
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 909545400 | Medicaid | MN |
Other providers in Glencoe, MN
- Glencoe Family Chiropractic, P.a.
- Glencoe Regional Health Services
- Glencoe Regional Health Services
- Glencoe Regional Health Services
- Glencoe Regional Health Services
- Lori Goebel
- Grand Meadows Senior Living
- Guardian in Home Health & Security, LLC
- Gwen Regnier DMD PLLC
- Hardy Dialysis LLC
All providers in Glencoe, 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 Sep 13, 2018. 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.