NPIMap

Organization Active NPI

Sheridan Memorial Hospital Association

  • Critical Access Hospital
  • Plentywood, MT
National Provider Identifier
1467452102
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
12506 Issued in MT
Legal business name
SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
Practice address
440 W Laurel Ave
Plentywood, MT 59254-1526
Phone
(406) 765-3700
Fax
(406) 765-3800
NPI assigned
Jul 22, 2005
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mr. Koday Nelson
Title
Ceo
Phone
(406) 765-3700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 12506 MT Primary
Ambulance 341600000X NU

Addresses

Primary practice location

440 W Laurel Ave
Plentywood, MT 59254-1526

Mailing address

440 W Laurel Ave
Plentywood, MT 59254-1526
Phone (406) 765-3700

Other identifiers 4

IdentifierTypeStateIssuer
60792OtherMTBC BS
0412556MedicaidMT
0442546MedicaidMT
0356720MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000492 MT Part A Provider - Critical Access Hospital 9133038706 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Plentywood, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467452102. Details of each certification follow.

Hospital certification: CCN 271322

Legal name
SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
Doing business as
SHERIDAN MEMORIAL HOSPITAL ASSOCIATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2002
Last certification
Mar 14, 2024
Beds
19
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1922 in MT
Enrollment address
440 West Laurel Avenue
Plentywood, MT 59254-1596
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 6

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
Sheridan Memorial HosptialCCN 271322 · 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
Tax ID family
Community Amb Serv7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: bkoessl@sheridanmemorial.cernerdirect.com
  • Direct secure messaging: ctrevino@sheridanmemorial.cernerdirect.com
  • Direct secure messaging: ekleppen@sheridanmemorial.cernerdirect.com
  • Direct secure messaging: jhoversland@sheridanmemorial.cernerdirect.com
  • Direct secure messaging: jklein4@sheridanmemorial.cernerdirect.com
  • Direct secure messaging: kmccolly@sheridanmemorial.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Lexi L Olson Individual Corporate Director Feb 24, 2024
Laura Rusbult Individual W-2 Managing Employee Apr 25, 1981
Donald Benson Individual Corporate Director Mar 22, 2017
Christopher Wiens Individual Corporate Director Feb 21, 2023
Nancy Jensen Individual Corporate Director Aug 23, 2017
Kody Nelson Individual Corporate OfficerCeo Aug 21, 2021
W-2 Managing Employee Aug 21, 2021
Myrnette Miller Individual Corporate Director Jan 1, 2014
Athena Gardenier Individual W-2 Managing Employee Nov 19, 2008
Paul Hansen Individual Corporate Director Feb 16, 2021

Practitioners & affiliated clinicians

Practitioners 18

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 18

Affiliated clinicians 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1467452102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 W LAUREL AVE",
            "city": "PLENTYWOOD",
            "state": "MT",
            "postal_code": "592541526",
            "telephone_number": "406-765-3700",
            "fax_number": "406-765-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W LAUREL AVE",
            "city": "PLENTYWOOD",
            "state": "MT",
            "postal_code": "592541526",
            "telephone_number": "406-765-3700",
            "fax_number": "406-765-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KODAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-765-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MT",
            "license": "12506",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "60792",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0412556",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442546",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0356720",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plentywood, MT

Sources for this page

Verify at the official NPI Registry.