Southwest Healthcare Services
Organization Active NPI Critical Access Hospital · Bowman, ND
NPI 1477529030 · NPPES record last updated Feb 9, 2021
Key facts
- NPI
- 1477529030
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 5006P (ND)
- Legal business name
- SOUTHWEST HEALTHCARE SERVICES
- Practice address
- 802 2ND St NW
Suite 1
Bowman, ND 58623 - Phone
- (701) 523-5555
- Fax
- (701) 523-7107
- NPI assigned
- Feb 24, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHWEST HEALTH CARE SERVICES
Authorized official
- Name
- Amanda Loughman
- Title
- Cfo
- Phone
- (701) 523-5555
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 6
Member organizations 2
Related certifications (CCN) 2
Practitioners 22
-
Jenna Corsiatto, APRN
-
Kurt G. Datz, D.O.
-
Christine R Peterson, FNP
-
William Logan Bender, M.D.
-
Melinda C Dalley, FNP
-
Daniel Donald Fuxa, CRNA
-
Patricia Gilbert, PA-C/L/ATC
-
Heather A Freitag, CRNA
-
William Mason Bone, MD, PHD
-
Matthew Frederick Feller, MD PA
-
Benjamin J Krogh, D.O.
-
Scott W Rigdon, CRNA
-
Nathaniel W Taggart, M.D.
-
Megan Maurya Oase, FNP-C
-
Stacie Marie Wellman, M.D.
-
Oscar Fernandez, M.D.
Affiliated clinicians 30
-
Kurt G. Datz, D.O.
-
Michael Fortney, M.D.
-
Marvin Go, MD
-
John H Holmen, M.D.
-
Mark S Kristy, MD
-
Kellie J Laumb, PAC
-
Jeffrey Thomas Maddock, M.D.
-
Joann Marie Nupen Lindemann, FNP-C
-
Megan Maurya Oase, FNP-C
-
Brianna Alyce Olson, DNP, APRN, FNP-C
-
Christine R Peterson, FNP
-
Mark G Peterson, MD
-
Joshua Ranum, MD
-
Luke B Roller, MD
-
Sarah Jeanne Stuchl, O.D.
-
Stacie Marie Wellman, M.D.
-
Jodi Lynn Wilson, MSN, FNP
-
William Logan Bender, M.D.
-
Melinda C Dalley, FNP
-
Daniel Donald Fuxa, CRNA
-
Patricia Gilbert, PA-C/L/ATC
Medicare Care Compare: Hospital
- Listed as
- Southwest Healthcare Services
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Hospital certification: CCN 351313
- Legal name
- SOUTHWESTHEALTHCARE SERVICES
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2001
- Last certification
- Sep 14, 2022
- Beds
- 35
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 1, 2001 in ND
- Enrollment address
- 802 2ND St NW
Bowman, ND 58623-4483
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Amanda J Loughman |
Corporate Officer | Nov 5, 2019 | |
| Dennis Goebel |
Corporate Director | Oct 15, 2021 | |
| Tina Marmon |
W-2 Managing Employee |
Nov 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000689 | ND | Part a Provider - Critical Access Hospital | 3173512704 |
Receives reassigned benefits from 18 practitioners Practice locations: Bowman, ND |
National Provider Directory
- Tax ID family
- Southwest Health Care Services
- Part of
- Southwest Health Care Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 5006P | ND | Yes |
| Ambulance | 341600000X |
Addresses
Primary practice location
802 2ND St NW
Suite 1
Bowman, ND 58623
Mailing address
802 2ND St NW
Suite 1
Bowman, ND 58623
Phone (701) 523-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01448 | Medicaid | ND | |
| 000497 | Other | ND | HOSPITAL |
| 1457848 | Medicaid | ND | |
| 012633 | Other | ND | AMBULANCE |
Other providers in Bowman, ND
- Debra Schade
- Roma Schade
- Alexander Shatalov
- Southwest Health Care Services
- Southwest Healthcare Services
- Southwest Healthcare Services
- Southwest Healthcare Services
- Southwest Healthcare Services
- Southwest Healthcare Services
- Southwest Healthcare Services
All providers in Bowman, ND · Critical Access Hospital 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 Feb 9, 2021. 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.