NPIMap

Organization Active NPI

Presentation Medical Center

  • Critical Access Hospital
  • Rolla, ND
National Provider Identifier
1265404958
Registry record updated Dec 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
5045 Issued in ND
Legal business name
PRESENTATION MEDICAL CENTER
Practice address
213 2ND Ave NE
Rolla, ND 58367-0759
Phone
(701) 477-3161
Fax
(701) 477-5564
NPI assigned
Feb 6, 2006
Last updated
Dec 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2013

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

Authorized official

Name
Ms. Paula J Wilkie
Title
Ceo
Phone
(701) 477-3161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 5045 ND Primary

Addresses

Primary practice location

213 2ND Ave NE
Rolla, ND 58367-0759

Mailing address

213 2ND Ave NE
Rolla, ND 58367-0759
Phone (701) 477-3161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041005001139 ND Part B Supplier - Clinic/Group Practice 5991764045 Receives reassigned benefits from 26 practitioners
Practice locations: Rolla, ND
O20101029001367 ND Part A Provider - Critical Access Hospital 5991764045 Receives reassigned benefits from 21 practitioners
Practice locations: Rolla, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265404958. Details of each certification follow.

Hospital certification: CCN 351316

Legal name
PRESENTATION MEDICAL CENTER
Doing business as
SMP HEALTH - ST. KATERI
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2001
Last certification
Apr 19, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Enrollment address
213 2ND Ave NE
Rolla, ND 58367-7153
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Presentation Medical CenterCCN 351316 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Jane Sivertson Individual Corporate DirectorBoard Member Oct 1, 2013
Lori Martinson Individual W-2 Managing EmployeeDirector of Nursing May 1, 2017
Presentation Medical Center Organization, Rolla, ND Operational/Managerial Control Jan 1, 1973
Paula Wilkie Individual Corporate Director Jan 1, 2010
Christopher Albertson Individual Corporate OfficerPreseident/Ceo Oct 1, 2017

Owners & managing parties with NPI records 2

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
SMP Health - St. KateriRolla, ND, CCN 35Z316 Hospital Operational/Managerial Control Jul 1, 2021

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 29

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 29

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1265404958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583670759",
            "telephone_number": "701-477-3161",
            "fax_number": "701-477-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583670759",
            "telephone_number": "701-477-3161",
            "fax_number": "701-477-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENTATION MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "WILKIE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-477-3161",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ND",
            "license": "5045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, ND

Sources for this page

Verify at the official NPI Registry.