NPIMap

Organization Active NPI

Lutheran Charity Association

  • Medicare Defined Swing Bed Hospital Unit
  • Jamestown, ND
National Provider Identifier
1184610347
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
5026A Issued in ND
Legal business name
LUTHERAN CHARITY ASSOCIATION
Practice address
2422 20TH St SW
Jamestown, ND 58401-6201
Phone
(701) 252-1050
Fax
(701) 952-3265
NPI assigned
Sep 23, 2005
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LUTHERAN CHARITY ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Mr. Michael J Delfs
Title
Ceo
Phone
(701) 952-4850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 5026A ND Primary

Addresses

Primary practice location

2422 20TH St SW
Jamestown, ND 58401-6201

Mailing address

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 252-1050

Other identifiers 1

IdentifierTypeStateIssuer
1452351MedicaidND

Other names 1

  • Jamestown Regional Medical Center Swingbed Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000525 ND Part A Provider - Critical Access Hospital 2264341031 Practice locations: Jamestown, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184610347. Details of each certification follow.

Hospital certification: CCN 35Z335

Legal name
LUTHERAN CHARITY ASSOCIATION
Doing business as
JAMESTOWN REGIONAL MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
May 27, 1927 in ND
Enrollment address
2422 20TH St SW
Jamestown, ND 58401-6201
Hospital Swing-Bed Unit

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).

National Provider Directory

National Provider Directory
Tax ID family
Jamestown Hospital7 organizations share this tax ID, including this one
Part of
Jamestown Hospital

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jeremy Robert Rham Individual Corporate Director Nov 1, 2022
Casey Henderson Individual Corporate DirectorBoard Member Mar 1, 2016
Compeer Financial Organization, Sun Prairie, WI 5% Or Greater Mortgage Interest Mar 25, 2010 21%
Amanda Kelly Thrift Individual Corporate Director Nov 1, 2022
Holly June Cherlynn Utke Individual Corporate DirectorBoard Member Nov 1, 2025
Michael J Delfs Individual Corporate OfficerPresident and Ceo Mar 1, 2019
W-2 Managing EmployeeAd; Mar 1, 2019
Lutheran Charity Association Organization, Jamestown, ND Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Clemens Jack Hager Individual Corporate Officer Nov 1, 2024
Usda Department of Agriculture Rural Development Organization, Bismarck, ND 5% Or Greater Mortgage Interest Mar 24, 2010 43%
Tania Falk Individual Corporate DirectorBoard Member Nov 1, 2023
Timothy Burchill Individual Corporate Director Mar 1, 2021
Derek J Schaff Individual Corporate OfficerVice President and Cfo Oct 1, 2025
W-2 Managing EmployeeAd; Oct 1, 2025
Sean Jordan Rinkenberger Individual Corporate Officer Nov 1, 2024
Briana Bohn Individual Corporate Director Nov 1, 2022
Steven Timothy Ottmar Individual Corporate Director Nov 1, 2019
Randall Lee Jaspers Individual Corporate Director Nov 1, 2019
Trisha Jungels Individual Corporate OfficerVice President and Cno Apr 15, 2013
W-2 Managing EmployeeAd; Apr 15, 2013

Owners & managing parties with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1184610347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-252-1050",
            "fax_number": "701-952-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-252-1050",
            "fax_number": "701-952-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN CHARITY ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN CHARITY ASSOCIATION",
        "enumeration_date": "2005-09-23",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "DELFS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-952-4850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "ND",
            "license": "5026A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452351",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamestown Regional Medical Center Swingbed",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jamestown Regional Medical Center Swingbed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.