Christian Unity Hospital Corporation
Organization Active NPI Critical Access Hospital · Grafton, ND
NPI 1073698262 · NPPES record last updated Aug 3, 2010
Key facts
- NPI
- 1073698262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- CHRISTIAN UNITY HOSPITAL CORPORATION
- Practice address
- 164 W 13TH St
Grafton, ND 58237-1826 - Phone
- (701) 352-1620
- Fax
- (701) 352-1671
- NPI assigned
- Oct 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Everett Allen Butler
- Title
- Ceo
- Phone
- (701) 352-1620
Owners & managing parties with NPI records 4
-
Matthew Stephen Viscito, M.D.
Owned or controlled facilities with NPI records 3
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Facilities with the same owner 3
Practitioners 28
-
Russell Andrew Kauffman, P.A.
-
Emily A Balsdon, FNP-C
-
Tricia Yvonne Buckalew, FNP-C
-
Dawn Christianson, FNP-C, FNP-BC
-
Tammie J. Harder, PA-C
-
Kaylina Kelley, PA-C
-
Jared Marquardt, MD
-
Kristi J Midgarden, M.D.
-
Jennifer D Shaw, M.D.
-
Whitney Thompson, PA-C
-
Matthew Stephen Viscito, M.D.
-
Jessica Raye Wichmann, PA-C
-
Tanner Grimsley, LAC
-
Jodi Lynn Sherve, FNP-C
-
Tabitha Elizabeth Clare Solc, FNP-C
Affiliated clinicians 4
-
Jared Marquardt, MD
-
Kristi J Midgarden, M.D.
-
Jennifer D Shaw, M.D.
-
Matthew Stephen Viscito, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Hospital certification: CCN 35Z320
- Legal name
- CHRISTIAN UNITY HOSPITAL CORPORATION
- Doing business as
- UNITY MEDICAL CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 24, 1970 in ND
- Enrollment address
- 164 W 13TH St
Grafton, ND 58237-1826
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Russell Carignan |
Corporate Director | Aug 1, 2018 | 100% |
| Todd Morgan |
Corporate Director | Aug 1, 2018 | 100% |
| Josephine Petersen |
Corporate Director |
Jul 10, 2013 | 100% |
| Heidi Paulson |
Corporate Director | Aug 1, 2018 | 100% |
| Paul Mohagen |
Corporate Director | Aug 1, 2018 | 100% |
| Alan W Oneil |
Corporate Officer |
Jun 1, 2014 | |
| Darla Hanson |
W-2 Managing Employee |
Mar 1, 2010 | 5% |
| Roger Gorder |
Corporate Director |
Jul 10, 2013 | 100% |
| Christian Unity Hospital Corporation |
5% Or Greater Direct Ownership Interest | Feb 3, 1971 | |
| Amy Vollrath |
Corporate Director |
Jul 10, 2013 | 100% |
| Bradley Wurgler |
W-2 Managing Employee |
May 18, 2020 | 100% |
| Matthew S Viscito |
Corporate Director | Aug 1, 2018 | 100% |
| Thomas Campbell |
Corporate Director | Aug 1, 2018 | 100% |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Unity Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest | Feb 3, 1971 |
| Unity Medical Center/Grafton Family Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Feb 3, 1971 |
| Park River Family Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Mar 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000234 | ND | Part a Provider - Critical Access Hospital | 8123925401 |
Receives reassigned benefits from 1 practitioner Practice locations: Grafton, ND |
National Provider Directory
- Tax ID family
- Christian Unity Hospital Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
164 W 13TH St
Grafton, ND 58237-1826
Mailing address
164 W 13TH St
Grafton, ND 58237-1826
Phone (701) 352-1620
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922 | Medicaid | ND | |
| 003178 | Other | ND | BC BS ND |
Other names
- UNITY MEDICAL CENTER-SWINGBED
Other providers in Grafton, ND
- Tricia Yvonne Buckalew
- Julie Callahan
- Michelle Kaye Carter
- Rachel Chalupnik
- Christian Unity Hospital Corp
- Christian Unity Hospital Corporation
- Christian Unity Hospital Corporation
- Dawn Christianson
- Community Health Service Inc.
- Maria C Contreras
All providers in Grafton, 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 Aug 3, 2010. 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.