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THE LODGE ON SUMMIT OAKS
NPI 1275717936
Assisted Living Facility in Burnsville, MN

Active since December 18, 2007CLIA 24D1084492 · Waiver
1412 SUMMIT OAKS DR, BURNSVILLE, MN 55337(952) 431-9120(952) 431-9123 Get Directions Write a Review

NPPES record last updated: January 26, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About The Lodge On Summit Oaks NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE LODGE ON SUMMIT OAKS (NPI 1275717936) is a healthcare organization registered as an assisted living facility in Burnsville, Minnesota and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through December 4, 2026 and lists Gerald John Mcgowan, Cfo, as its authorized official.

NPPES Registry Identity

NPI1275717936
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameMINNESOTA COMMUNITY HOSPICE INC
Location Address1412 SUMMIT OAKS DRBurnsville, MN 55337-4744
Mailing Address1412 Summit Oaks DrBurnsville, MN 55337-4744 · (952) 431-9120 · Fax (952) 431-9123
Phone(952) 431-9120
Fax(952) 431-9123
Organization SubpartYes
Authorized OfficialGerald John McgowanCfo · (651) 319-1295
Enumeration DateDecember 18, 2007
Last NPPES UpdateJanuary 26, 2015
✔ NPI 1275717936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · CLASS F HOME CARE PR
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1412 SUMMIT OAKS DR, Burnsville, MN 55337
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Other Names 1

Doing Business AsThe Lodge On Summit Oaks

Other Identifiers 1

Medicaid789488000MN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1084492

The Lodge On Summit Oaks · Burnsville, MN
Active · expires Dec 4, 2026
CLIA Number24D1084492
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 5, 2024
Certificate Expiration DateDecember 4, 2026
Laboratory DirectorTyneisha Stowers
Laboratory Phone(612) 200-0901
Laboratory LocationThe Lodge On Summit Oaks1412 Summit Oaks Drive, Burnsville, MN 55337
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINNESOTA COMMUNITY HOSPICE INC
Assisted Living Facility
1412 SUMMIT OAKS DR
BURNSVILLE, MN 55337
Dakota County (952) 431-9120
THE LODGES COMPANY
Assisted Living Facility
1412 SUMMIT OAKS DR
BURNSVILLE, MN 55337
Dakota County (612) 986-3859

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Minnesota Community Hospice Inc's NPI number?

The NPI number for Minnesota Community Hospice Inc is 1275717936. It was assigned to this organization in the NPPES registry on December 18, 2007. The provider is doing business as The Lodge On Summit Oaks.

Where is Minnesota Community Hospice Inc located?

Minnesota Community Hospice Inc is located at 1412 Summit Oaks Dr, Burnsville, MN 55337. The listed phone number is (952) 431-9120.

What is Minnesota Community Hospice Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Minnesota Community Hospice Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1084492) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Minnesota Community Hospice Inc was last updated on January 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.