NPIMap

Organization Active NPI

Glendive Medical Center, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Glendive, MT
National Provider Identifier
1073523635
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
10541 Issued in MT
Legal business name
GLENDIVE MEDICAL CENTER, INC
Practice address
202 Prospect Dr
Glendive, MT 59330-1943
Phone
(406) 345-3306
Fax
(406) 345-3358
NPI assigned
Aug 8, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
William Robinson
Title
VP of Financial Services
Phone
(406) 345-8924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 10541 MT Primary

Addresses

Primary practice location

202 Prospect Dr
Glendive, MT 59330-1943

Mailing address

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306

Other identifiers 2

IdentifierTypeStateIssuer
00003100110MedicaidMT
00082OtherMTBLUE CROSS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061104000114 MT Part A Provider - Critical Access Hospital 7214846823 Receives reassigned benefits from 39 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendive, MT
O20071001000411 MT Part A Provider - Critical Access Hospital 7214846823 Receives reassigned benefits from 2 practitioners
Practice locations: Glendive, MT

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1073523635. Details of each certification follow.

Hospital certification: CCN 271332

Legal name
GLENDIVE MEDICAL CENTER INC
Doing business as
GLENDIVE MEDICAL CENTER INC.
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2003
Last certification
Aug 30, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 27, 1964 in MT
Enrollment address
202 Prospect Dr
Glendive, MT 59330-1943
Other Hospital Practice Location

Hospital certification: CCN 27Z332

Legal name
GLENDIVE MEDICAL CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Nov 27, 1964 in MT
Enrollment address
202 Prospect Dr
Glendive, MT 59330-1943

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

Other NPIs with the same Medicare PAC ID 5

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
Glendive Medical CenterCCN 271332 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Hospital Crna Dept12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
A'Lynn Shields Individual Corporate Director May 1, 2016
Parker a Powell Individual Contracted Managing EmployeeChief Executive Officer Oct 11, 2013
Corporate OfficerChief Executive Officer Oct 11, 2013
Lesley Gibbs Individual Corporate Director Feb 27, 2025
Randy H Thompson Individual Corporate Director Jul 1, 2024
John Schallenkamp Individual Corporate Director Oct 1, 2013
Corporate Director Aug 5, 1970
Joseph M Leal Individual Corporate Director Feb 25, 2021
Billings Clinic Organization, Billings, MT Corporation, Non-profit Operational/Managerial Control Sep 1, 2013
Chrystal Lynn Potter Individual Corporate Director Jan 1, 2016
Janette Bogar Individual Corporate Director Feb 25, 2021
Troy D Myers Individual Corporate Director Feb 23, 2023
William Robinson Individual Corporate OfficerVice-President of Financial Service Aug 3, 2015
W-2 Managing Employee Aug 3, 2015
W-2 Managing EmployeeVice-President of Finance Aug 3, 2015

Owners & managing parties with NPI records 11

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

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 33

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 33

Affiliated clinicians 134

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 134

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1073523635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PROSPECT DR",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301943",
            "telephone_number": "406-345-3306",
            "fax_number": "406-345-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PROSPECT DR",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301943",
            "telephone_number": "406-345-3306",
            "fax_number": "406-345-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDIVE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "VP OF FINANCIAL SERVICES",
        "authorized_official_telephone_number": "406-345-8924"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MT",
            "license": "10541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00003100110",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00082",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.