NPIMap

Organization Active NPI

Liberty County Hospital and Nursing Home, Inc

Doing business as Logan Health Rural Health Clinic- Chester

  • Rural Health Clinic/Center
  • Chester, MT
National Provider Identifier
1003984097
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LIBERTY COUNTY HOSPITAL AND NURSING HOME, INC
Doing business as
Logan Health Rural Health Clinic- Chester
Practice address
418 West Monroe Avenue
Chester, MT 59522-0506
Phone
(406) 759-5194
NPI assigned
Nov 30, 2006
Last updated
Apr 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Cherie Taylor
Title
President
Phone
(406) 873-3736

Specialties & licenses 1

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

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 names 1

  • Logan Health Rural Health Clinic- Chester Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Liberty County Hospital and Nursing Home, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003984097. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Jul 1, 1998 in MT
Enrollment address
418 W Monroe Ave
Chester, MT 59522-7835
Related CCNs
271334

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

Other NPIs with the same Medicare PAC ID 2

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Tim Bronk Individual Corporate Director Dec 1, 2017
Anna Robbins Individual Operational/Managerial Control Jul 12, 2023
Justin Ott Individual Corporate Officer Aug 28, 2024
Heidi M Duncan Individual Corporate Director Sep 1, 2023
Melissa Lundbeck Kaptanian Individual Corporate Director Aug 28, 2024
Ellen Layton Individual Corporate Officer Aug 28, 2024
Brigid B Burke Individual Corporate Officer May 8, 2024
Mtwy Health Organization, Kalispell, MT Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2022
Operational/Managerial Control Jul 1, 2022
Jane Karas Individual Corporate Director Sep 1, 2023
Kirk Skari Individual Corporate Director Nov 1, 2018
Clinton W Seger Individual Corporate Officer Sep 1, 2023
Corporate Director Sep 1, 2023
Alice Gordon Individual Corporate Director Sep 1, 2023
Patti L Pilgrim Individual Corporate Officer Jan 6, 2025
Craig Bartholomew Individual Corporate Director Sep 1, 2023
Rudy Cicon Individual Corporate Director Dec 1, 2020
Cherie Taylor Individual Corporate Officer Oct 11, 2023
W-2 Managing Employee Oct 11, 2023
William D Gibson Individual Corporate Officer Jul 1, 2022
Larry Hendrickson Individual Corporate Director Jul 1, 2017
Michael L Goguen Individual Corporate Director Sep 1, 2023
Michelle Harris Individual Corporate Director Sep 1, 2023
Karla Kulpas Individual Corporate Director Dec 1, 2020
Keith Cook Individual Corporate Director Sep 1, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 24

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

View all 24

Change-of-ownership history 2

DateEventCounterparty
Jul 1, 2022 Change of OwnershipThis provider was the buyer Triangle Health CareCCN 273994, MT, NPI 1003984097
Jul 1, 2022 Change of OwnershipThis provider was the seller Logan Health Rural Health Clinic - ChesterCCN 273994, MT, NPI 1003984097

Practitioners & affiliated clinicians

Practitioners 67

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 67

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1003984097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "CHESTER",
            "state": "MT",
            "postal_code": "595220705",
            "telephone_number": "406-759-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 WEST MONROE AVENUE",
            "city": "CHESTER",
            "state": "MT",
            "postal_code": "595220506",
            "telephone_number": "406-759-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COUNTY HOSPITAL AND NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CHERIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-873-3736"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Liberty County Hospital and Nursing Home, Inc",
            "address_1": "315 West Madison Avenue",
            "city": "Chester",
            "state": "MT",
            "country_code": "US",
            "postal_code": "595220705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Logan Health Rural Health Clinic- Chester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, MT

Sources for this page

Verify at the official NPI Registry.