NPIMap

Organization Active NPI

Northwood Deaconess Health Center

  • Critical Access Hospital
  • Northwood, ND
National Provider Identifier
1356449136
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
5040P Issued in ND
Legal business name
NORTHWOOD DEACONESS HEALTH CENTER
Practice address
4 North Park St
Northwood, ND 58267-0190
Phone
(701) 587-6060
Fax
(701) 587-6492
NPI assigned
Sep 20, 2006
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Brock Sherva
Title
Ceo
Phone
(701) 587-6060

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 5040P ND Primary
Clinical Medical Laboratory 291U00000X 35D0684526 ND
Ambulance 341600000X

Addresses

Primary practice location

4 North Park St
Northwood, ND 58267-0190

Mailing address

PO Box 190
Northwood, ND 58267-0190
Phone (701) 587-6060

Other identifiers 5

IdentifierTypeStateIssuer
623348100MedicaidMN
0174OtherNDBCBS
D01045MedicaidND
1000064OtherMEDICARE PART B
11827MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040226000123 ND Part B Supplier - Clinic/Group Practice 1052207057 Receives reassigned benefits from 22 practitioners
5 other NPIs on this enrollment
Practice locations: Northwood, ND
O20061104000683 ND Part A Provider - Critical Access Hospital 1052207057 Receives reassigned benefits from 17 practitioners
Practice locations: Northwood, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356449136. Details of each certification follow.

Hospital certification: CCN 351312

Legal name
NORTHWOOD DEACONESS HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2001
Last certification
Jan 25, 2023
Beds
7
Ownership / control type
Church
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1956 in ND
Enrollment address
4 N Park St
Northwood, ND 58267-4102
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Northwood Deaconess Health CenterCCN 351312 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Brock Sherva Individual Contracted Managing EmployeeCeo Jan 1, 2023
Corporate OfficerCeo Jan 1, 2023
Corporate DirectorCeo Jan 1, 2023
Operational/Managerial ControlCeo Jan 1, 2023
Robert Bilden Individual Corporate Director Mar 26, 2008

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Northwood Deaconess Health CenterNorthwood, ND, CCN 35Z312 Hospital Operational/Managerial Control Jan 1, 1990

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

Affiliated clinicians 39

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1356449136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "NORTHWOOD",
            "state": "ND",
            "postal_code": "582670190",
            "telephone_number": "701-587-6060",
            "fax_number": "701-587-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NORTH PARK ST",
            "city": "NORTHWOOD",
            "state": "ND",
            "postal_code": "582670190",
            "telephone_number": "701-587-6060",
            "fax_number": "701-587-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOOD DEACONESS HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "SHERVA",
        "authorized_official_first_name": "BROCK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-587-6060"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ND",
            "license": "5040P",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ND",
            "license": "35D0684526",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623348100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0174",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D01045",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "1000064",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11827",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northwood, ND

Sources for this page

Verify at the official NPI Registry.