Griggs County Nursing Home
Organization Active NPI Skilled Nursing Facility · Cooperstown, ND
NPI 1144500596 · NPPES record last updated Apr 3, 2014
Key facts
- NPI
- 1144500596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1012A (ND)
- Legal business name
- GRIGGS COUNTY NURSING HOME
- Practice address
- 1200 Roberts Ave NE
Cooperstown, ND 58425-7101 - Phone
- (701) 797-2221
- Fax
- (701) 797-2421
- NPI assigned
- Aug 17, 2011
- Organization subpart
- No
Authorized official
- Name
- Nicole Johnson
- Title
- Acting Administrator
- Phone
- (701) 797-2221
Practitioners 2
-
Jonathon H Berg, MD
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Griggs County Care Center
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 1, 1978
- Medicare certification status
- Active
- Certified beds
- 40 · 37.5 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Skilled nursing facility certification: CCN 355039
- Legal name
- GRIGGS COUNTY NURSING HOME
- Doing business as
- GRIGGS COUNTY CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1978
- Last certification
- Jul 31, 2024
- Beds
- 40
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 1, 2011 in ND
- Enrollment address
- 107 12TH St S
Cooperstown, ND 58425-4501 - Nursing home name
- GRIGGS COUNTY CARE CENTER
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Benjamin Halvorson |
Corporate Director |
Apr 19, 2022 | |
| Judy Monson |
Corporate Officer |
Jun 1, 2023 | |
| W-2 Managing Employee |
Jun 1, 2023 | ||
| Nicole Johnson |
Corporate Officer |
Jan 19, 2014 | |
| W-2 Managing Employee |
Feb 1, 2014 | ||
| Operational/Managerial Control |
Aug 15, 2013 | ||
| Janice Johnson |
Corporate Director |
Feb 6, 2021 | |
| Joann Larson |
Corporate Director |
Aug 16, 2023 | |
| Daniel Larson |
Corporate Director |
Apr 19, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110819000150 | ND | Part a Provider - Skilled Nursing Facility | 2668642109 | Practice locations: Cooperstown, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1012A | ND | Yes |
Addresses
Primary practice location
1200 Roberts Ave NE
Cooperstown, ND 58425-7101
Mailing address
1200 Roberts Ave NE
Cooperstown, ND 58425-7101
Phone (701) 797-2221
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30509 | Medicaid | ND | |
| 1107 | Other | ND | BLUE CROSS BLUE SHIELD |
Other names
- Griggs County Care Center
Other providers in Cooperstown, ND
- Cooperstown Medical Center
- Rachel Marie Dahl
- Essential Chiropractic PLLC
- Brooke Leigh Fredrickson
- Griggs County
- Cia Gronneberg
- Kevin S Jacobson
- Annette Robin Krabbenhoft
- Kali Susan Manz
- Kristine Louise Martin
All providers in Cooperstown, ND · Skilled Nursing Facility 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 3, 2014. 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.