NPIMap

Organization Active NPI

Welia Health

  • Critical Access Hospital Clinic/Center
  • Mora, MN
National Provider Identifier
1972811362
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
Legal business name
WELIA HEALTH
Practice address
301 Highway 65 S
Mora, MN 55051-1899
Phone
(320) 679-1313
Fax
(320) 674-9060
NPI assigned
Sep 20, 2010
Last updated
Jul 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
WELIA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Randy Ulseth
Title
Ceo
Phone
(320) 679-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X MN Primary

Addresses

Primary practice location

301 Highway 65 S
Mora, MN 55051-1899

Mailing address

301 Highway 65 S
Mora, MN 55051-1899
Phone (320) 679-1212

Other names 1

  • Welia Health Mora Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210722002959 MN Part A Provider - Critical Access Hospital 6709295496 Receives reassigned benefits from 147 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mora, MN
O20220125001227 MN Part B Supplier - Clinic/Group Practice 6709295496 Receives reassigned benefits from 181 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mora, MN; Pine City, MN; Hinckley, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972811362. Details of each certification follow.

Hospital certification: CCN 241367

Legal name
WELIA HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 1, 2005
Last certification
Feb 9, 2005
Beds
49 (25 certified)
Ownership / control type
Local
Most recent change of ownership
Jul 1, 2021 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 13, 2020 in MN
Enrollment address
301 Highway 65 S
Mora, MN 55051-1899
Main/Primary Hospital Location

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Welia HealthCCN 241367 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Welia Health

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Peter J Donner Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Kim E Smith Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Mary K Ellis Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Amy a Anderson Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Julie J Schmidt Individual Corporate OfficerChro Jul 16, 2019 20%
Rebecca L Steffen Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Sandra Zutz-Wiczek Individual Corporate OfficerCoo Jan 12, 2015 20%
Theresa a Heggernes Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Joshua R Asp Individual Corporate OfficerCfo Sep 26, 2016 20%
Randy W Ulseth Individual Corporate OfficerCeo Jan 1, 2002 20%
Sheila L Peterson Individual W-2 Managing Employee Jul 1, 2021
Jack D Schwinghamer Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Carl O Pederson Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%
Ellen K Ryan Individual Corporate OfficerCqo Aug 14, 1995 20%
Leslie B Nielsen Individual Corporate DirectorBoard Member Jul 1, 2021 11.11%

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 51

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 51

Affiliated clinicians 192

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

View all 192

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1972811362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1212",
            "fax_number": "320-225-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1313",
            "fax_number": "320-674-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELIA HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELIA HEALTH",
        "enumeration_date": "2010-09-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "ULSETH",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-679-1212"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welia Health Mora",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mora, MN

Sources for this page

Verify at the official NPI Registry.