Liberty County Hospital and Nursing Home, Inc
Organization Active NPI Rural Health Clinic/Center · Chester, MT
NPI 1003984097 · NPPES record last updated Apr 30, 2025
Key facts
- NPI
- 1003984097
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- LIBERTY COUNTY HOSPITAL AND NURSING HOME, INC
- Practice address
- 418 West Monroe Avenue
Chester, MT 59522-0506 - Phone
- (406) 759-5194
- NPI assigned
- Nov 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Cherie Taylor
- Title
- President
- Phone
- (406) 873-3736
Owners & managing parties with NPI records 2
-
Heidi M. Duncan, MD
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 1
Facilities with the same owner 24
Practitioners 67
-
Timothy R Blair Sr., APRN
-
Nick Cade Cantrell, M.D.
-
Amanda Marie Engman, FNP
-
Michael Henson, M.D.
-
Katie Kelleher, DNP, APRN, FNP-C
-
David E. Mangold, PA-C
-
Blaine G White, PA-C
-
Scott Alan Alexander, M.D.
-
Lance E Flesch, MD
-
Chadwick Garner, M.D.
-
Jared Heath Heimbigner, D.O.
-
Kara Heuvelhorst, D.O.
-
Jason Hibbard, M.D.
-
Erik Andrew Jacobson, M.D.
-
James McKee, M.D.
-
Christopher Sharpe, APN
-
Darren Young, PA-C
-
Andrew J. Ziegert, M.D.
-
Jeffrey B Chandler, PA-C
-
Henry Tucker Clay Jr., M.D.
-
Paul Richard Bradbury, PA-S
-
Rich R Stowe, PA
-
Frank C Towsley Jr., P.A.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT
Rural health clinic certification: CCN 273994
- Legal name
- LIBERTY COUNTY HOSPITAL AND NURSING HOME INC
- Doing business as
- LOGAN HEALTH RURAL HEALTH CLINIC - CHESTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 1, 2000
- Last certification
- Apr 3, 2025
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 1, 1998 in MT
- Enrollment address
- 418 W Monroe Ave
Chester, MT 59522-7835 - Related CCNs
- 271334
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Tim Bronk |
Corporate Director | Dec 1, 2017 | |
| Anna Robbins |
Operational/Managerial Control | Jul 12, 2023 | |
| Justin Ott |
Corporate Officer | Aug 28, 2024 | |
| Heidi M Duncan |
Corporate Director | Sep 1, 2023 | |
| Melissa Lundbeck Kaptanian |
Corporate Director | Aug 28, 2024 | |
| Ellen Layton |
Corporate Officer | Aug 28, 2024 | |
| Brigid B Burke |
Corporate Officer | May 8, 2024 | |
| Mtwy Health |
5% Or Greater Direct Ownership Interest | Jul 1, 2022 | |
| Operational/Managerial Control | Jul 1, 2022 | ||
| Jane Karas |
Corporate Director | Sep 1, 2023 | |
| Kirk Skari |
Corporate Director | Nov 1, 2018 | |
| Clinton W Seger |
Corporate Officer | Sep 1, 2023 | |
| Corporate Director | Sep 1, 2023 | ||
| Alice Gordon |
Corporate Director | Sep 1, 2023 | |
| Patti L Pilgrim |
Corporate Officer | Jan 6, 2025 | |
| Craig Bartholomew |
Corporate Director | Sep 1, 2023 | |
| Rudy Cicon |
Corporate Director | Dec 1, 2020 | |
| Cherie Taylor |
Corporate Officer | Oct 11, 2023 | |
| W-2 Managing Employee | Oct 11, 2023 | ||
| William D Gibson |
Corporate Officer | Jul 1, 2022 | |
| Larry Hendrickson |
Corporate Director | Jul 1, 2017 | |
| Michael L Goguen |
Corporate Director | Sep 1, 2023 | |
| Michelle Harris |
Corporate Director | Sep 1, 2023 | |
| Karla Kulpas |
Corporate Director | Dec 1, 2020 | |
| Keith Cook |
Corporate Director | Sep 1, 2023 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jul 1, 2022 | Change of Ownership |
Triangle Health Care |
| Jul 1, 2022 | Change of Ownership |
Logan Health Rural Health Clinic - Chester |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040115000815 | MT | Part B Supplier - Clinic/Group Practice | 0042128480 |
Receives reassigned benefits from 64 practitioners 1 other NPI on this enrollment Practice locations: Chester, MT |
| O20220804001712 | MT | Part a Provider - Rural Health Clinic | 0042128480 | Practice locations: Chester, MT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
418 West Monroe Avenue
Chester, MT 59522-0506
Mailing address
PO Box 705
Chester, MT 59522-0705
Phone (406) 759-5194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0720273 | Medicaid | MT | |
| 100001242 | Medicaid | MT |
Other names
- Logan Health Rural Health Clinic- Chester
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krmcmedicalrecords@krhdirect.org | Liberty County Hospital and Nursing Home, Inc |
Other providers in Chester, MT
- Jill Elizabeth Leblanc
- Liberty County
- Liberty County
- Liberty County Hospital & Nursing Home Inc
- Liberty County Hospital and Nursing Home Inc
- Liberty County Hospital and Nursing Home, Inc
- Jerry D Martin
- Kurt Matkin
- Kerry Kaye Mattson
- Pharmfill Inc
All providers in Chester, MT · Rural Health Clinic/Center in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.