Active NPI
Marian Manor Community Corporation
- Skilled Nursing Facility
- Glen Ullin, ND
On this page
- Key facts
- NPPES NPI Registry
- Medicare participation
- All disclosed owners & managing parties10
- National Provider Directory
- Owners & managing parties with NPI records6
- Subparts reporting this organization as parent1
- Facilities with the same owner1
- Affiliated clinicians1
- Care Compare: Nursing home
- Laboratory certificates & supplier records
- NPI Registry JSON
- Other providers in Glen Ullin, ND
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1025A
- Legal business name
- MARIAN MANOR COMMUNITY CORPORATION
- Practice address
- 604 E Ash Ave
Glen Ullin, ND 58631-7138 - Phone
- (701) 348-3107
- NPI assigned
- Aug 9, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Sandra F Gerving
- Title
- Administrator
- Phone
- (701) 348-3107
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1025A | ND | Primary |
Addresses
Primary practice location
604 E Ash Ave
Glen Ullin, ND 58631-7138
Mailing address
PO Box 578
Glen Ullin, ND 58631-0578
Phone (701) 348-3107
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30067 | Medicaid | ND |
Other names 1
- Marian Manor Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060404000599 | ND | Part A Provider - Skilled Nursing Facility | 4981612884 | Practice locations: Glen Ullin, ND |
Skilled nursing facility certification: CCN 355036
- Legal name
- MARIAN MANOR COMMUNITY CORPORATION
- Doing business as
- MARIAN MANOR HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1978
- Last certification
- Mar 13, 2025
- Beds
- 54
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Nov 26, 1963 in ND
- Enrollment address
- 604 E Ash Ave
Glen Ullin, ND 58631-7138 - Nursing home name
- MARIAN MANOR HEALTHCARE CENTER
All disclosed owners & managing parties 10
Medicare enrollment filesAs disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Sandra Gerving | Operational/Managerial Control | Mar 10, 2015 | |
| Adp of the SNF | Mar 10, 2015 | ||
| Jacobson Memorial Hospital Care Center | Operational/Managerial Control | Oct 13, 2022 | |
| Adp of the SNF | Oct 13, 2022 | ||
| Diane Schirado | Corporate Director | Apr 4, 2006 | |
| Operational/Managerial Control | Apr 4, 2006 | ||
| Adp of the SNF | Apr 4, 2006 | ||
| Timothy Duppong | Corporate Director | Dec 11, 2012 | |
| Adp of the SNF | Dec 11, 2012 | ||
| Lee Kiedrowski | Operational/Managerial Control | Feb 1, 2026 | |
| Adp of the SNF | Feb 1, 2026 | ||
| Jenny Hellman | Corporate Director | Apr 14, 2015 | |
| Adp of the SNF | Apr 14, 2015 | ||
| Bruce Morman | Corporate Director | Jan 1, 2016 | |
| Adp of the SNF | Jan 1, 2016 | ||
| Heidi Peltz | Corporate Director | Feb 10, 2015 | |
| Adp of the SNF | Feb 10, 2015 | ||
| Charles Gerving | Corporate Director | Apr 4, 2006 | |
| Adp of the SNF | Apr 4, 2006 | ||
| Andrew Cotant | Operational/Managerial Control | Apr 24, 2025 | |
| Adp of the SNF | Apr 24, 2025 |
National Provider Directory
National Provider DirectoryOwners & managing parties with NPI records 6
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Rural Health Clinic/Center
- Glen Ullin, ND
- NPI 1003929944
Adp of the SNF, Operational/Managerial Control
-
- Rural Health Clinic/Center
- Richardton, ND
- NPI 1043649486
Adp of the SNF, Operational/Managerial Control
-
- Medicare Defined Swing Bed Hospital Unit
- Elgin, ND
- NPI 1184002347
Adp of the SNF, Operational/Managerial Control
-
- Critical Access Hospital
- Elgin, ND
- NPI 1336196039
Adp of the SNF, Operational/Managerial Control
-
- Rural Health Clinic/Center
- Elgin, ND
- NPI 1871691519
Adp of the SNF, Operational/Managerial Control
-
- Family Medicine Physician
- Bismarck, ND
- NPI 1962997338
Adp of the SNF, Operational/Managerial Control
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Custodial Care Facility
- Glen Ullin, ND
- NPI 1457224370
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Rural Health Clinic/Center
- Richardton, ND
- NPI 1043649486
Jacobson Memorial Hospital Care Center
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Marian Manor Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 1, 1978
- Medicare certification status
- Active
- Certified beds
- 54
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D0655701 | Marian Manor Health Care Center | Certificate of waiver | Aug 31, 2026 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576540800000",
"number": "1316948631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 578",
"city": "GLEN ULLIN",
"state": "ND",
"postal_code": "586310578",
"telephone_number": "701-348-3107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 E ASH AVE",
"city": "GLEN ULLIN",
"state": "ND",
"postal_code": "586317138",
"telephone_number": "701-348-3107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIAN MANOR COMMUNITY CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-09",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A",
"authorized_official_last_name": "GERVING",
"authorized_official_first_name": "SANDRA",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "701-348-3107",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "ND",
"license": "1025A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30067",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Marian Manor Healthcare Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Marian Manor Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Glen Ullin, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.