Organization Active NPI

Marian Manor Community Corporation

  • Skilled Nursing Facility
  • Glen Ullin, ND
National Provider Identifier
1316948631
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1025A Issued in ND
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

Updated by the provider on Dec 17, 2019

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
30067MedicaidND

Other names 1

  • Marian Manor Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 files

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

NameRoleSinceShare
Sandra Gerving Individual Operational/Managerial Control Mar 10, 2015
Adp of the SNF Mar 10, 2015
Jacobson Memorial Hospital Care Center Organization, Elgin, ND Corporation Operational/Managerial Control Oct 13, 2022
Adp of the SNF Oct 13, 2022
Diane Schirado Individual Corporate DirectorSecretary/Treasurer Apr 4, 2006
Operational/Managerial Control Apr 4, 2006
Adp of the SNF Apr 4, 2006
Timothy Duppong Individual Corporate DirectorVice President Dec 11, 2012
Adp of the SNF Dec 11, 2012
Lee Kiedrowski Individual Operational/Managerial Control Feb 1, 2026
Adp of the SNF Feb 1, 2026
Jenny Hellman Individual Corporate Director Apr 14, 2015
Adp of the SNF Apr 14, 2015
Bruce Morman Individual Corporate Director Jan 1, 2016
Adp of the SNF Jan 1, 2016
Heidi Peltz Individual Corporate Director Feb 10, 2015
Adp of the SNF Feb 10, 2015
Charles Gerving Individual Corporate DirectorPresident Apr 4, 2006
Adp of the SNF Apr 4, 2006
Andrew Cotant Individual Operational/Managerial Control Apr 24, 2025
Adp of the SNF Apr 24, 2025

National Provider Directory

National Provider Directory

Owners & managing parties with NPI records 6

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

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.

Facilities with the same owner 1

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

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 CenterCCN 355036
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5451.8 residents per day on average
Penalties (3 years)
1Fines totaling $22,835

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0655701Marian Manor Health Care Center604 Ash Ave E, Glen Ullin, ND 58631Certificate of waiverAug 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

Verify at the official NPI Registry.