NPIMap

Organization Active NPI

Warren Community Hospital, Inc.

Doing business as North Valley Health Center

  • Rural Health Clinic/Center
  • Warren, MN
National Provider Identifier
1972642213
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WARREN COMMUNITY HOSPITAL, INC.
Doing business as
North Valley Health Center
Practice address
300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone
(218) 745-4211
Fax
(218) 745-4215
NPI assigned
Feb 5, 2007
Last updated
Aug 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Mr. Jon Earl Linnell
Title
Ceo
Phone
(218) 745-4211

Specialties & licenses 1

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

Addresses

Primary practice location

300 W Good Samaritan Dr
Warren, MN 56762-1412

Mailing address

300 W Good Samaritan Dr
Warren, MN 56762-1412
Phone (218) 745-4211

Other names 1

  • North Valley Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccd@direct.northvalleyhealth.org Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040908000953 MN Part B Supplier - Clinic/Group Practice 2264408566 Receives reassigned benefits from 112 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Warren, MN
O20110316000747 MN Part A Provider - Rural Health Clinic 2264408566 Practice locations: Warren, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972642213. Details of each certification follow.

Rural health clinic certification: CCN 243409

Legal name
WARREN COMMUNITY HOSPITAL INC
Doing business as
NORTH VALLEY HEALTH CENTER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 18, 1997
Last certification
Jun 8, 2017
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1980 in MN
Enrollment address
300 W Good Samaritan Dr
Warren, MN 56762-1412
Related CCNs
241337

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Warren Hospital Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Darlene Dvorak Individual Corporate Director Jun 1, 2023
Shari Swanson Individual Corporate Director Jan 1, 2017
Mitchell Kotrba Individual Corporate OfficerCfo May 18, 2010
Corporate Director May 18, 2010
W-2 Managing EmployeeCfo May 18, 2010
Operational/Managerial ControlCfo May 18, 2010
Warren Community Hospital Inc Organization, Warren, MN Non-profit Operational/Managerial Control Aug 14, 1980 100%
Jason Boman Individual Corporate Director Jun 1, 2013
Jon E Linnell Individual Corporate OfficerCeo Jan 1, 2016
Corporate DirectorCeo Jan 1, 2016
W-2 Managing EmployeeCeo Jan 1, 2016
Operational/Managerial ControlCeo Jan 1, 2016
James Widner Individual Corporate Director Jun 1, 2013
Jeff Hanson Individual Corporate Director Jun 1, 2018
Mallory Craik Individual Corporate Director Jun 1, 2020
Mark Yutrzenka Individual Corporate Director Jun 1, 2023
Ron Leverington Individual Corporate Director Jun 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Warren Community Hospital IncWarren, MN, CCN 241337 Hospital Operational/Managerial Control (100%) Nov 20, 2013
North Valley Health CenterWarren, MN, CCN 24Z337 Hospital Operational/Managerial Control May 18, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1972642213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W GOOD SAMARITAN DR",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621412",
            "telephone_number": "218-745-4211",
            "fax_number": "218-745-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W GOOD SAMARITAN DR",
            "city": "WARREN",
            "state": "MN",
            "postal_code": "567621412",
            "telephone_number": "218-745-4211",
            "fax_number": "218-745-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "LINNELL",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-745-4211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccd@direct.northvalleyhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 W Good Samaritan Dr",
            "city": "Warren",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567621412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "North Valley Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Valley Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MN

Sources for this page

Verify at the official NPI Registry.