Griggs County Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1012A Issued in ND

Legal business name

GRIGGS COUNTY NURSING HOME

Doing business as

Griggs County Care Center

Practice address

1200 Roberts Ave NE
Cooperstown, ND 58425-7101

Phone

(701) 797-2221

Fax

(701) 797-2421

NPI assigned

Aug 17, 2011

Last updated

Apr 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Johnson

Title

Acting Administrator

Phone

(701) 797-2221

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Griggs County Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144500596. Details of each certification follow.

• CCN 355039 Skilled nursing facility · Active · Details

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

CorporationNon-profit

Incorporated

Jul 1, 2011 in ND

Enrollment address

107 12TH St S
Cooperstown, ND 58425-4501

Nursing home name

GRIGGS COUNTY CARE CENTER

Listed as

Griggs County Care CenterCCN 355039 · All quality measures

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

ActiveFrom the Provider of Services file

Certified beds

4037.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 6

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

Practitioners 2

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.

• Jonathon H Berg, MD

  • Family Medicine Physician
  • Grand Forks, ND
  • NPI 1073513982
  NPD (past)
• William G McKinnon, MD

  • Family Medicine Physician
  • Cooperstown, ND
  • NPI 1881786218
  NPD (past)

Affiliated clinicians 1

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

• William G McKinnon, MD

  • Family Medicine Physician
  • Cooperstown, ND
  • NPI 1881786218

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1144500596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROBERTS AVE NE",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584257101",
            "telephone_number": "701-797-2221",
            "fax_number": "701-797-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROBERTS AVE NE",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584257101",
            "telephone_number": "701-797-2221",
            "fax_number": "701-797-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIGGS COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "ACTING ADMINISTRATOR",
        "authorized_official_telephone_number": "701-797-2221"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1012A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1107",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30509",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Griggs County Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cooperstown Medical Center (CMC Rural Health Clinic)
• Rachel Marie Dahl, PHARM D
• Essential Chiropractic PLLC (Essential Chiropractic)
• Brooke Leigh Fredrickson, LRD, CSG
• Griggs County
• Cia Gronneberg
• Kevin S Jacobson, NP
• Annette Robin Krabbenhoft
• Kali Susan Manz, CNP
• Kristine Louise Martin, APRN-CNP

• Skilled Nursing Facility in Cooperstown, ND
• Providers in Cooperstown, ND by specialty
• Skilled Nursing Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.