NPIMap

Organization Active NPI

Strand-Kjorsvig Community Rest Home

  • Skilled Nursing Facility
  • Roslyn, SD
National Provider Identifier
1265688980
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0083 Issued in SD
Legal business name
STRAND-KJORSVIG COMMUNITY REST HOME
Practice address
801 S Main St
Roslyn, SD 57261-0195
Phone
(605) 486-4523
Fax
(605) 486-4376
NPI assigned
Aug 13, 2008
Last updated
Feb 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Authorized official

Name
Roxann Kjos, RN
Title
Administrator
Phone
(605) 486-4523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10673 SD
Skilled Nursing Facility 314000000X 0083 SD Primary

Addresses

Primary practice location

801 S Main St
Roslyn, SD 57261-0195

Mailing address

801 South Main Street
Roslyn, SD 57261-0195
Phone (605) 486-4523

Other identifiers 3

IdentifierTypeStateIssuer
0160140MedicaidSD
9566260MedicaidSD
9572380MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081006000618 SD Part A Provider - Skilled Nursing Facility 9638247588 3 other NPIs on this enrollment
Practice locations: Roslyn, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265688980. Details of each certification follow.

Skilled nursing facility certification: CCN 435125

Legal name
STRAND-KJORSVIG COMMUNITY REST HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 25, 2008
Last certification
May 8, 2025
Beds
35
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1955 in SD
Enrollment address
801 Main St
Roslyn, SD 57261
Nursing home name
STRAND-KJORSVIG COMMUNITY REST HOME

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Strand-Kjorsvig Community Rest HomeCCN 435125 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 25, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3529.8 residents per day on average
Penalties (3 years)
7Fines totaling $41,495

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Strand-Kjorsvig Community Rest Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Shannon L Schmidt Individual Corporate OfficerCeo Jun 4, 2012
Operational/Managerial Control Jun 4, 2012
Lonnie Aadland Individual Corporate Director Nov 17, 2015
Krissa Samson Individual Corporate OfficerBoard Secretary Oct 16, 2008
Helen Trautner Individual Operational/Managerial Control Aug 25, 2008
Mark Hanson Individual Corporate Director May 1, 2018
Doug Eidahl Individual Corporate Director Nov 20, 2018
Shelley Deutsch Individual Corporate Director Aug 25, 2008

Practitioners & affiliated clinicians

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": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234742400000",
    "number": "1265688980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SOUTH MAIN STREET",
            "city": "ROSLYN",
            "state": "SD",
            "postal_code": "572610195",
            "telephone_number": "605-486-4523",
            "fax_number": "605-486-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MAIN ST",
            "city": "ROSLYN",
            "state": "SD",
            "postal_code": "572610195",
            "telephone_number": "605-486-4523",
            "fax_number": "605-486-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRAND-KJORSVIG COMMUNITY REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2009-02-16",
        "status": "A",
        "authorized_official_last_name": "KJOS",
        "authorized_official_first_name": "ROXANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-486-4523",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "10673",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "0083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160140",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9566260",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9572380",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, SD

Sources for this page

Verify at the official NPI Registry.