NPIMap

Organization Active NPI

Glendive Medical Center, Inc

  • Rural Health Clinic/Center
  • Glendive, MT
National Provider Identifier
1215040449
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GLENDIVE MEDICAL CENTER, INC
Practice address
107 Dilworth St
Glendive, MT 59330-2053
Phone
(406) 345-8901
Fax
(406) 345-8908
NPI assigned
Aug 15, 2006
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 11

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

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Facilities with the same owner 14

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

View all 14

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101207001239 MT Part A Provider - Rural Health Clinic 7214846823 Practice locations: Glendive, MT

Rural health clinic certification: CCN 273411

Legal name
GLENDIVE MEDICAL CENTER INC
Doing business as
GABERT CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 1, 2005
Last certification
Apr 29, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 27, 1964 in MT
Enrollment address
107 Dilworth St
Glendive, MT 59330-2053
Related CCNs
271332

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

All disclosed owners & managing parties 11

Medicare enrollment files

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 Officer Oct 11, 2013
Lesley Gibbs Individual Corporate DirectorBoard Director Feb 27, 2025
Randy H Thompson Individual Corporate DirectorBoard Director Jul 1, 2024
John Schallenkamp Individual Corporate Director Oct 1, 2013
Joseph M Leal Individual Corporate Director Feb 1, 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 1, 2021
Troy D Myers Individual Corporate Director Feb 23, 2023
William Robinson Individual Corporate OfficerVice President of Finance Aug 3, 2015
W-2 Managing EmployeeVice-President of Finance Aug 3, 2015

National Provider Directory

National Provider Directory
Tax ID family
Glendvive Medical Cente12 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.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

107 Dilworth St
Glendive, MT 59330-2053

Mailing address

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
0720562MedicaidMT
8882OtherMTBLUE CROSS RHC

Other names 1

NPPES NPI Registry
  • GABERT CLINIC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 4, 2021.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1215040449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901",
            "fax_number": "406-345-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901",
            "fax_number": "406-345-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDIVE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720562",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RHC",
            "identifier": "8882",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GABERT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GABERT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.