NPIMap

Organization Active NPI

St Aloisius Hospital Inc

Doing business as St Aloisius Medical Center Clinic

  • Rural Health Clinic/Center
  • Harvey, ND
National Provider Identifier
1477045052
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST ALOISIUS HOSPITAL INC
Doing business as
St Aloisius Medical Center Clinic
Practice address
317 Brewster St E
Harvey, ND 58341
Phone
(701) 324-4651
Fax
(701) 324-4687
NPI assigned
May 31, 2018
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ST ALOISIUS HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Afred K Sams
Title
Ceo
Phone
(701) 324-5101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

317 Brewster St E
Harvey, ND 58341

Mailing address

317 Brewster St E
Harvey, ND 58341-1653
Phone (701) 324-4651

Other names 1

  • ST ALOISIUS MEDICAL CENTER CLINIC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040422000286 ND Part B Supplier - Clinic/Group Practice 6002802378 Receives reassigned benefits from 29 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fessenden, ND; Harvey, ND
O20200915001551 ND Part A Provider - Rural Health Clinic 6002802378 Practice locations: Harvey, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477045052. Details of each certification follow.

Rural health clinic certification: CCN 358509

Legal name
ST ALOISIUS HOSPITAL, INC.
Doing business as
SMP HEALTH - ST. ALOISIUS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 26, 2021
Last certification
May 26, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 31, 1948 in ND
Enrollment address
317 Brewster St E
Harvey, ND 58341-1653
Related CCNs
351327

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 2

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

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
35D2190722St Aloisius Medical Center Clinic317 Brewster St E, Harvey, ND 58341Certificate of waiverAug 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
St Aloisius Clinic3 organizations share this tax ID, including this one
Part of
St Aloisius Clinic

Other organizations with this tax ID 2

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

Locations

325 Brewster St E
Harvey, ND 58341
Phone (701) 324-4651

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Kathy Muscha Individual Corporate Director Jul 1, 2024
Sisters of Mary of the Presentation Health System Organization, Fargo, ND Corporation, Non-profit Operational/Managerial Control Jan 1, 1973
Ryan L Mickelsen Individual Corporate OfficerCeo Jan 30, 2023
W-2 Managing EmployeeAd; Jan 30, 2023
Nicole Anderson Individual Corporate OfficerCfo Jun 1, 2024
Gordon Schmidt Individual Corporate Director Jul 20, 2017
Doug Heil Individual Corporate DirectorDirector Jul 1, 2025
St Aloisius Hospital, Inc. Organization, Harvey, ND Corporation, Non-profit Operational/Managerial Control Aug 3, 2020
Anne G Picard Individual Corporate Director Jul 1, 2024
Mary Hager Individual Corporate Director Jul 1, 2024
Steven C Kourajian Individual Corporate DirectorDirector Jul 1, 2024
Debra Berry Individual Corporate Director Sep 1, 2019

Owners & managing parties with NPI records 4

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

Facilities with the same owner 8

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1477045052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 BREWSTER ST E",
            "city": "HARVEY",
            "state": "ND",
            "postal_code": "583411653",
            "telephone_number": "701-324-4651",
            "fax_number": "701-324-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BREWSTER ST E",
            "city": "HARVEY",
            "state": "ND",
            "postal_code": "58341",
            "telephone_number": "701-324-4651",
            "fax_number": "701-324-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ALOISIUS HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST ALOISIUS HOSPITAL INC",
        "enumeration_date": "2018-05-31",
        "last_updated": "2022-06-01",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "AFRED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-324-5101"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ALOISIUS MEDICAL CENTER CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST ALOISIUS MEDICAL CENTER CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harvey, ND

Sources for this page

Verify at the official NPI Registry.