NPIMap

Organization Active NPI

Dahl Memorial Healthcare Association Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Ekalaka, MT
National Provider Identifier
1245389980
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
12555 Issued in MT
Legal business name
DAHL MEMORIAL HEALTHCARE ASSOCIATION INC
Practice address
106 E Park St
Ekalaka, MT 59324-0046
Phone
(406) 775-8739
Fax
(406) 775-6479
NPI assigned
Jan 10, 2007
Last updated
Feb 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Mr. Ryan Tooke
Title
Ceo
Phone
(406) 775-8739

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 12555 MT Primary

Addresses

Primary practice location

106 E Park St
Ekalaka, MT 59324-0046

Mailing address

PO Box 46
Ekalaka, MT 59324-0046
Phone (406) 775-8730

Other identifiers 2

IdentifierTypeStateIssuer
7100171MedicaidMT
1245389980MedicaidMT

Other names 1

  • Dahl Memorial Swingbed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080516000330 MT Part A Provider - Critical Access Hospital 1658323373 Receives reassigned benefits from 1 practitioner
Practice locations: Ekalaka, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245389980. Details of each certification follow.

Hospital certification: CCN 27Z302

Legal name
DAHL MEMORIAL HEALTHCARE ASSOCIATION INC
Doing business as
DAHL MEMORIAL SWINGBED
Organization structure
CorporationNon-profit
Incorporated
Oct 12, 1988 in MT
Enrollment address
106 E Park St
Ekalaka, MT 59324
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Dahl Memorial Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/dahlmem-def2a17d

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
John Marks Individual Corporate DirectorBoard Member Sep 18, 2023
Dahl Memorial Healthcare Association Inc Organization, Ekalaka, MT Corporation, Non-profit Operational/Managerial Control May 21, 2008
Jonathan Deford Individual Corporate DirectorBoard Member Sep 18, 2023
Georgia Bruski Individual Corporate DirectorBoard Member Sep 18, 2018
Marilyn Schultz Individual Corporate DirectorBoard Member Sep 1, 2022
Rusty Spencer Individual Corporate DirectorBoard Member Sep 1, 2022
Jitt Schneider Individual Corporate DirectorBoard Member Sep 17, 2015
Darrell Messersmith Individual Corporate OfficerCeo Jul 1, 2024
W-2 Managing Employee Jul 1, 2024 100%
Troy Fruit Individual Corporate DirectorBoard Member Sep 17, 2015
Jennimarie Ingram Individual W-2 Managing EmployeeController Nov 23, 2024

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dahl Memorial Healthcare Association IncEkalaka, MT, CCN 271302 Hospital Operational/Managerial Control May 21, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1245389980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46",
            "city": "EKALAKA",
            "state": "MT",
            "postal_code": "593240046",
            "telephone_number": "406-775-8730",
            "fax_number": "406-775-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E PARK ST",
            "city": "EKALAKA",
            "state": "MT",
            "postal_code": "593240046",
            "telephone_number": "406-775-8739",
            "fax_number": "406-775-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAHL MEMORIAL HEALTHCARE ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "TOOKE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-775-8739",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MT",
            "license": "12555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100171",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245389980",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dahl Memorial Swingbed",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dahl Memorial Swingbed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ekalaka, MT

Sources for this page

Verify at the official NPI Registry.