NPIMap

Organization Active NPI

Bennett County Hospital and Nursing Home

  • Critical Access Hospital
  • Martin, SD
National Provider Identifier
1437187044
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BENNETT COUNTY HOSPITAL AND NURSING HOME
Practice address
102 Major Allen St
Martin, SD 57551-6005
Phone
(605) 685-6622
NPI assigned
Jun 30, 2006
Last updated
Nov 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Authorized official

Name
Mike Jager
Title
It Manager
Phone
(605) 685-6622

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SD
Critical Access Hospital 282NC0060X SD Primary
Pharmacy 333600000X 100-2050 SD
Long Term Care Pharmacy 3336L0003X 100-2050 SD

Addresses

Primary practice location

102 Major Allen St
Martin, SD 57551-6005

Mailing address

PO Box 70
Martin, SD 57551-0070
Phone (605) 685-6622

Other identifiers 10

IdentifierTypeStateIssuer
5500790MedicaidSD
81314OtherSDBLUE CROSS
9011382MedicaidSD
9550312MedicaidSD
0170792MedicaidSD
0006944OtherSDBLUE CROSS
0150180MedicaidSD
0159320MedicaidSD
0100790MedicaidSD
9001122MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20050128000369 SD Part B Supplier - Clinic/Group Practice 9234194960 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Martin, SD
O20061104000402 SD Part A Provider - Critical Access Hospital 9234194960 Receives reassigned benefits from 5 practitioners
Practice locations: Martin, SD
O20070129000624 SD Part A Provider - Critical Access Hospital 9234194960 Practice locations: Martin, SD
O20160201002841 SD Part A Provider - Rural Health Clinic 9234194960 Practice locations: Martin, SD

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1437187044. Details of each certification follow.

Hospital certification: CCN 431314

Legal name
BENNETT COUNTY HOSPITAL AND NURSING HOME
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2000
Last certification
Apr 25, 2024
Beds
14
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 2005 (1 total)
Organization structure
OtherNon-profit
Incorporated
Jan 23, 2004 in SD
Enrollment address
102 Major Allen St
Martin, SD 57551-0070
Main/Primary Hospital Location

Hospital certification: CCN 43Z314

Legal name
BENNETT COUNTY HOSPITAL AND NURSING HOME
Organization structure
OtherNon-profit
Incorporated
Jan 23, 2004 in SD
Enrollment address
102 Major Allen
Martin, SD 57551-0070
Main/Primary Hospital Location

Rural health clinic certification: CCN 433442

Legal name
BENNETT COUNTY HOSPITAL AND NURSING HOME
Doing business as
BENNETT COUNTY RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 14, 2016
Last certification
Nov 20, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 23, 2004 in SD
Enrollment address
102 Major Allen St
Martin, SD 57551-6005
Related CCNs
431314

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bennett County Hospital and Nursing Home - CahCCN 431314 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

102 Major Allen St
#70
Martin, SD 57551
Phone (605) 685-6622

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Dale McDonnell Individual Corporate DirectorBoard Member Jan 1, 2005
Corporate OfficerSecretary/Treasurer Jan 1, 2005 100%
Corporate DirectorSecretary/Treasurer Jan 1, 2005 100%
Bradley Otte Individual Corporate DirectorBoard Member Jan 1, 2006
Corporate DirectorMember Jan 1, 2006 100%
Jeffrey D Johnson Individual Corporate DirectorBoard Member Jun 1, 2018
Corporate Director Jun 1, 2018
Judy Soderlin Individual Corporate OfficerCfo Mar 1, 2012
W-2 Managing EmployeeCfo Dec 11, 2014
Timothy Huether Individual Corporate DirectorBoard Member Sep 1, 2025
Corporate DirectorBoard Member Aug 28, 2025
David Jones Individual Corporate DirectorBoard Member Jan 1, 2005
Corporate OfficerPresident of the Board Jan 1, 2005 100%
Corporate DirectorPresident of the Board Jan 1, 2005 100%
Shandel Anson Individual Corporate OfficerManaging Employee Mar 11, 2024
Operational/Managerial ControlCeo Mar 11, 2025
Jason Fanning Individual Corporate DirectorBoard Member Nov 22, 2022
Corporate DirectorMember Nov 22, 2022
Mark Lyons Individual Contracted Managing EmployeeCpa Jan 1, 2012 100%
Michael Christensen Individual Corporate OfficerCeo Mar 29, 2021
W-2 Managing EmployeeCeo Mar 29, 2021
Stephanie Moran Individual Corporate OfficerCoo Jun 20, 2021
Bennett County Hospital and Nursing Home Organization, Martin, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 15, 2016 100%
Operational/Managerial Control Feb 15, 2016 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

Affiliated clinicians 9

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": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1437187044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "MARTIN",
            "state": "SD",
            "postal_code": "575510070",
            "telephone_number": "605-685-6622",
            "fax_number": "605-685-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAJOR ALLEN ST",
            "city": "MARTIN",
            "state": "SD",
            "postal_code": "575516005",
            "telephone_number": "605-685-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT COUNTY HOSPITAL AND NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "JAGER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "IT MANAGER",
        "authorized_official_telephone_number": "605-685-6622"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SD",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "SD",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "SD",
            "license": "100-2050",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "SD",
            "license": "100-2050",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5500790",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "81314",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9011382",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9550312",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170792",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0006944",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150180",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159320",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100790",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001122",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martin, SD

Sources for this page

Verify at the official NPI Registry.