NPIMap

Organization Active NPI

Pioneer Memorial Hospital & Health Services

  • Medicare Defined Swing Bed Hospital Unit
  • Viborg, SD
National Provider Identifier
1265467245
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
48541 Issued in SD
Legal business name
PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES
Practice address
315 N Washington Street
Viborg, SD 57070-0368
Phone
(605) 326-5161
Fax
(605) 326-5734
NPI assigned
Jul 11, 2006
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
PIONEER MEMORIAL HOSPITAL & HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Georgia Pokorney
Title
Chief Executive Officer
Phone
(605) 326-5161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 48541 SD Primary

Addresses

Primary practice location

315 N Washington Street
Viborg, SD 57070-0368

Mailing address

PO Box 368
Viborg, SD 57070-0368
Phone (605) 326-5161

Other identifiers 1

IdentifierTypeStateIssuer
0159140MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120309000379 SD Part A Provider - Critical Access Hospital 9234042755 Practice locations: Viborg, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265467245. Details of each certification follow.

Hospital certification: CCN 43Z328

Legal name
PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1959 in SD
Enrollment address
315 N Washington St
Viborg, SD 57070-2002

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
Pioneer Memorial Hosp10 organizations share this tax ID, including this one
Part of
Pioneer Memorial Hosp

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Troy Lee Individual Corporate DirectorTrustee Mar 28, 2016
Anne Marie Christiansen Individual Corporate OfficerCfo Jan 27, 2017
Corporate Director Jan 27, 2017
W-2 Managing EmployeeCfo Mar 1, 2002
Paul D Christensen Individual Corporate OfficerVice President Mar 1, 2002
Melanie L Parsons Individual Corporate Director Mar 1, 2005 11%
Sharon Jacobsen Individual W-2 Managing EmployeeDirector of Nursin Nov 30, 2011 100%
Tonya Rudd Individual Corporate Director Jul 1, 2019
W-2 Managing Employee Jul 1, 2019
Issac Gerdes Individual W-2 Managing EmployeeAd; Jun 28, 2024
Pioneer Memorial Hospital & Health Services Organization, Viborg, SD Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Pioneer Memorial HospitalViborg, SD, CCN 431328 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 1959
Pioneer Memorial Nursing HomeViborg, SD, CCN 435120 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Apr 1, 2004
Dec 10, 2024
Dec 17, 2024
Parker Medical ClinicParker, SD, CCN 433427 Rural health clinic 5% Or Greater Direct Ownership Interest May 27, 2010
Centerville Medical ClinicCenterville, SD, CCN 433428 Rural health clinic 5% Or Greater Direct Ownership Interest May 27, 2010
Viborg Medical ClinicViborg, SD, CCN 433993 Rural health clinic 5% Or Greater Direct Ownership Interest May 27, 2010

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 5

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 5

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1265467245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "VIBORG",
            "state": "SD",
            "postal_code": "570700368",
            "telephone_number": "605-326-5161",
            "fax_number": "605-326-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON STREET",
            "city": "VIBORG",
            "state": "SD",
            "postal_code": "570700368",
            "telephone_number": "605-326-5161",
            "fax_number": "605-326-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "POKORNEY",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "605-326-5161"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "SD",
            "license": "48541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159140",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viborg, SD

Sources for this page

Verify at the official NPI Registry.