St Aloisius Hospital Inc
Organization Active NPI Rural Health Clinic/Center · Harvey, ND
NPI 1477045052 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1477045052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ST ALOISIUS HOSPITAL INC
- Practice address
- 317 Brewster St E
Harvey, ND 58341 - Phone
- (701) 324-4651
- Fax
- (701) 324-4687
- NPI assigned
- May 31, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- ST ALOISIUS HOSPITAL INC
Authorized official
- Name
- Afred K Sams
- Title
- Ceo
- Phone
- (701) 324-5101
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 4
-
Steven Charles Kourajian, O.D.
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 2
Related certifications (CCN) 1
Facilities with the same owner 8
Practitioners 22
-
Aaron J Albers, DPM
-
Blendi Cumani, MD
-
Tuan Kishfran Imran Dean, M.D.
-
Robert L Fischer, MD
-
Kelly D Krohn, M.D.
-
Deborah Buxa, FNP
-
Rick J Geier, MD
-
Michael L Hammer, DNP
-
Daniel K Lee, DO
-
Lisa M Neumiller, NFP
-
Charles D Nyhus, MD
-
Michael J Page, MD
-
Robert H Rotering, M.D.
-
Kim A Thorson, FNP-C
-
Steven F Arnold, NP-C
-
Arden Milton Beachy, M.D.
-
Tyesha Dawn Marie Dent, PA-C
-
Lee Allen Ellingson, CRNA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D2190722 | St Aloisius Medical Center Clinic | Certificate of waiver | Aug 17, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND
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
- Corporation · Non-profit
- Incorporated
- Oct 31, 1948 in ND
- Enrollment address
- 317 Brewster St E
Harvey, ND 58341-1653 - Related CCNs
- 351327
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Kathy Muscha |
Corporate Director | Jul 1, 2024 | |
| Sisters of Mary of the Presentation Health System |
Operational/Managerial Control | Jan 1, 1973 | |
| Ryan L Mickelsen |
Corporate Officer |
Jan 30, 2023 | |
| W-2 Managing Employee |
Jan 30, 2023 | ||
| Nicole Anderson |
Corporate Officer |
Jun 1, 2024 | |
| Gordon Schmidt |
Corporate Director | Jul 20, 2017 | |
| Doug Heil |
Corporate Director |
Jul 1, 2025 | |
| St Aloisius Hospital, Inc. |
Operational/Managerial Control | Aug 3, 2020 | |
| Anne G Picard |
Corporate Director | Jul 1, 2024 | |
| Mary Hager |
Corporate Director | Jul 1, 2024 | |
| Steven C Kourajian |
Corporate Director |
Jul 1, 2024 | |
| Debra Berry |
Corporate Director | Sep 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- St Aloisius Mmedical Ce
- Part of
- St Aloisius Mmedical Ce
Locations
325 Brewster St E
Harvey, ND 58341
Phone (701) 324-4651
317 Brewster St E
Harvey, ND 58341
Phone (701) 324-5131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- ST ALOISIUS MEDICAL CENTER CLINIC
Other providers in Harvey, ND
- Sears Enterprises LLC
- Selzler Pharmacy Inc
- Carol M Selzler
- Service Drug and Gift Inc
- St Aloisius Hospital Inc
- St Aloisius Hospital Inc
- St Aloisius Hospital Inc
- Steven C. Kourajian, O.D., P.C.
- Jeanna Thompson
- Hiltrud Thurmann
All providers in Harvey, ND · Rural Health Clinic/Center in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.