St. Alexius Medical Center
Organization Active NPI Critical Access Hospital · Turtle Lake, ND
NPI 1013961820 · NPPES record last updated Apr 21, 2017
Key facts
- NPI
- 1013961820
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 5059 (ND)
- Legal business name
- ST. ALEXIUS MEDICAL CENTER
- Practice address
- 220 5TH Ave W
Turtle Lake, ND 58575-4324 - Phone
- (701) 448-2331
- Fax
- (701) 448-2441
- NPI assigned
- May 19, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CATHOLIC HEALTH INITIATIVES
Authorized official
- Name
- Tod Graeber
- Title
- Administrator
- Phone
- (701) 463-6505
Owners & managing parties with NPI records 19
-
Laura Archuleta, M.D.
-
Timothy J Bopp, MD
-
Kevin R Dahmen, M.D.
-
Calvin Motika, M.D
-
Todd M Preszler, M.D.
-
Luke B Roller, MD
-
Parveen Suhara Wahab, M.D
-
Syed Shiraz Hyder, M.D.
Owned or controlled facilities with NPI records 6
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 11
Related certifications (CCN) 3
Facilities with the same owner 6
Practitioners 240
-
Jason Hahn, RPT
-
Jenni Hetletved, PA-C
-
Ashley Murrey, PMHNP
-
Makayla Vaughan, FNP
-
Susan Wardner, FNP
-
Kaitlyn Rae Wirtz, PA-C
-
Jon E Dornacker, MD
-
Forrest Leroy Hirsch, FNP-C
-
Jessica L Ahmann, DNP, APRN, FNP-BC
-
Danielle Rae Anderson, PA-C
-
Laura Archuleta, M.D.
-
Brieann Leigh Backes, PA-C
-
Rhonda Kae Bieber, DNP, APRN, FNP-C
-
Amanda Susan Braaten, M.D.
-
Nicholas Coren Bradbury, M.D.
-
Kristin Braun, FNP
-
Mandi L Braun, PA-C
-
Rachel Joan Brunsell, FNP
-
Jordan Michael Buchholz, PA-C
-
Rebekah Charchenko, CRNA
-
Cody Chathams, CRNA
-
Ling Sing Chow, M.D.
Affiliated clinicians 16
-
Kayla Marie Abrahamson, DNP, FNP-C
-
Jill Renee Goven, FNP
-
Matthew L. Hamar, D.O.
-
Brian J Hebert, MD
-
Jenni Hetletved, PA-C
-
Forrest Leroy Hirsch, FNP-C
-
Melissa Renae McClintock, FNP-C
-
Ashley Murrey, PMHNP
-
Amanda Schmidt, FNP
-
Makayla Vaughan, FNP
-
Susan Wardner, FNP
-
Kellie Weisenburger, FNP
-
Kaitlyn Rae Wirtz, PA-C
Medicare Care Compare: Hospital
- Listed as
- CHI St Alexius Health Turtle Lake
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in ND
Hospital certification: CCN 351304
- Legal name
- ST ALEXIUS MEDICAL CENTER
- Doing business as
- CHI ST. ALEXIUS HEALTH TURTLE LAKE
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2000
- Last certification
- Jan 31, 2024
- Beds
- 25
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 1, 1990 in ND
- Enrollment address
- 220 5TH Ave W
Turtle Lake, ND 58575-4324
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Todd Michael Preszler |
Corporate Director |
Jul 1, 2022 | |
| Timothy J Bopp |
Corporate Director |
Jul 1, 2020 | |
| Stacy Schaffer |
Corporate Officer |
Oct 23, 2024 | |
| Commonspirit Health |
5% Or Greater Direct Ownership Interest | Feb 1, 2019 | 100% |
| Reed E Reyman |
Corporate Officer |
Dec 19, 2022 | |
| W-2 Managing Employee |
Dec 19, 2022 | ||
| Operational/Managerial Control |
Dec 19, 2022 | ||
| Nicole Kunze |
Corporate Director |
Jul 1, 2023 | |
| Matt Schanandore |
Corporate Officer |
Oct 23, 2024 | |
| Syed Shiraz Shiraz Hyder |
Corporate Director |
Jul 1, 2021 | |
| John Giese |
Corporate Director |
Jul 1, 2019 | |
| Luke B Roller |
Corporate Director |
Oct 23, 2024 | |
| Calvin Motika |
Corporate Officer |
Oct 23, 2024 | |
| Laura J Archuleta |
Corporate Director |
Oct 23, 2024 | |
| Mike Weisbeck |
Corporate Director |
Jul 1, 2022 | |
| Parveen Suhara Wahab |
Corporate Officer |
Oct 23, 2024 | |
| Kevin R Dahmen |
Corporate Director |
Jul 1, 2022 | |
| Rosanne Zastoupil |
Corporate Officer |
Jul 1, 2022 | |
| St Alexius Medical Center |
5% Or Greater Direct Ownership Interest | Jul 1, 1990 | 100% |
| Operational/Managerial Control | Jul 1, 1990 | 100% | |
| John Mongeon |
Corporate Director |
Jul 1, 2021 | |
| Rosanne Schmidt |
Corporate Director |
Oct 23, 2024 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Garrison Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1997 |
| CHI St. Alexius Health Garrison |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 1990 |
| CHI St. Alexius Health Turtle Lake |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 30, 1990 Jul 30, 1990 |
| Garrison Memorial Hospital |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Jun 22, 1998 |
| Garrison Family Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1997 |
| Commonspirit Health |
Rural health clinic | 5% Or Greater Direct Ownership Interest (90%) Operational/Managerial Control (100%) |
Jun 30, 1999 Jun 30, 1999 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031104000146 | ND | Part B Supplier - Clinic/Group Practice | 8426960865 |
Receives reassigned benefits from 654 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bismarck, ND; Mandan, ND; Minot, ND; Turtle Lake, ND; Washburn, ND |
| O20101029001339 | ND | Part a Provider - Critical Access Hospital | 8426960865 |
Receives reassigned benefits from 9 practitioners Practice locations: Turtle Lake, ND |
| O20150305000250 | ND | Part B Supplier - Hospital Department(S) | 8426960865 |
Receives reassigned benefits from 1 practitioner 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bismarck, ND |
National Provider Directory
- Part of
- Catholic Health Initiatives
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 5059 | ND | Yes |
Addresses
Primary practice location
220 5TH Ave W
Turtle Lake, ND 58575-4324
Mailing address
PO Box 280
Turtle Lake, ND 58575-0280
Phone (701) 448-2331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1454338 | Medicaid | ND |
Other names
- CHI St. Alexius Health Turtle Lake
Other providers in Turtle Lake, ND
- Juliana Chioma Nwachukwu
- Rachelle Samantha Ravnaas
- Karakae Reiser
- Amber Lynn Schneider
- Julaine Smith
- St. Alexius Medical Center
- St. Alexius Medical Center
- St. Alexius Medical Center
- Kimberly K Sundquist
- Carrie Lynn Thompson Widmer
All providers in Turtle Lake, ND · Critical Access Hospital in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2017. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.