Cooperstown Medical Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1012A Issued in ND

Legal business name

COOPERSTOWN MEDICAL CENTER

Doing business as

Cooperstown Medical Center Nursing Home

Practice address

1200 Roberts Ave NE
Cooperstown, ND 58425-7101

Phone

(701) 797-2221

NPI assigned

Sep 29, 2006

Last updated

May 14, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

COOPERSTOWN MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Gregory Stomp, RN, LNHA

Title

Administrator/Ceo

Phone

(701) 797-2221

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cooperstown Medical Center Nursing Home Doing business as

Part of

Cooperstown Medical Center

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1285726067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROBERTS AVE NE",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584257101",
            "telephone_number": "701-797-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROBERTS AVE NE",
            "city": "COOPERSTOWN",
            "state": "ND",
            "postal_code": "584257101",
            "telephone_number": "701-797-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERSTOWN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOPERSTOWN MEDICAL CENTER",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "STOMP",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "701-797-2221",
        "authorized_official_credential": "RN, LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1012A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ND",
            "identifier": "1107",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30095",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooperstown Medical Center Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cortney Beattie, PT, DPT
• Norman Leo Berthiaume, FNP-C
• City of Cooperstown
• Cooperstown Medical Center (Cooperstown Medical Center DME)
• Cooperstown Medical Center (Cooperstown Medical Center Critical Access Hospital)
• Cooperstown Medical Center (Cooperstown Medical Center Swing Bed)
• Cooperstown Medical Center (CMC Rural Health Clinic)
• Rachel Marie Dahl, PHARM D
• Essential Chiropractic PLLC (Essential Chiropractic)
• Brooke Leigh Fredrickson, LRD, CSG

• Skilled Nursing Facility in Cooperstown, ND
• Providers in Cooperstown, ND by specialty
• Skilled Nursing Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.