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MINNESOTA VETERANS HOME - MONTEVIDEO
NPI 1407562309
Skilled Nursing Facility in Montevideo, MN

Active since January 25, 2023CLIA 24D2294848 · Waiver
2190 WILLIAM AVENUE, MONTEVIDEO, MN 56265(320) 301-0429(612) 548-5964 Get Directions Write a Review

NPPES record last updated: December 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 3, 2024, Jan 25, 2023 (2 updates tracked since 2023).

About Minnesota Veterans Home - Montevideo NPPES

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

MINNESOTA VETERANS HOME - MONTEVIDEO (NPI 1407562309) is a healthcare organization registered as a skilled nursing facility in Montevideo, Minnesota and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through November 29, 2027 and lists Simone Renee Hogan, Mdva Chief Operations Director, as its authorized official.

NPPES Registry Identity

NPI1407562309
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSTATE OF MINNESOTA - MINNESOTA MANAGEMENT AND BUDGET
Location Address2190 WILLIAM AVENUEMontevideo, MN 56265-2273
Mailing Address5101 Minnehaha Ave. SMinneapolis, MN 55417-1647
Phone(320) 301-0429
Fax(612) 548-5964
Organization SubpartYes
Authorized OfficialSimone Renee HoganMdva Chief Operations Director · (612) 505-4110
Enumeration DateJanuary 25, 2023
Last NPPES UpdateDecember 3, 20242 updates tracked since enumeration
NPPES CertifiedDecember 3, 2024
✔ NPI 1407562309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2190 WILLIAM AVENUE, Montevideo, MN 56265
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Other Names 1

Doing Business AsMinnesota Veterans Home - Montevideo

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 24D2294848

Minnesota Veterans Home Montevideo · Montevideo, MN
Active · expires Nov 29, 2027
CLIA Number24D2294848
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateNovember 30, 2025
Certificate Expiration DateNovember 29, 2027
Laboratory DirectorSean Ercan-Fang
Laboratory Phone(320) 435-4710
Laboratory LocationMinnesota Veterans Home Montevideo2190 William Avenue, Montevideo, MN 56265
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 State Of Minnesota - Minnesota Management And Budget's NPI number?

The NPI number for State Of Minnesota - Minnesota Management And Budget is 1407562309. It was assigned to this organization in the NPPES registry on January 25, 2023. The provider is doing business as Minnesota Veterans Home - Montevideo.

Where is State Of Minnesota - Minnesota Management And Budget located?

State Of Minnesota - Minnesota Management And Budget is located at 2190 William Avenue, Montevideo, MN 56265. The listed phone number is (320) 301-0429.

What is State Of Minnesota - Minnesota Management And Budget's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does State Of Minnesota - Minnesota Management And Budget hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2294848) is associated with this NPI, valid through November 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for State Of Minnesota - Minnesota Management And Budget was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.