NPIMap

Organization Active NPI

Southwest Healthcare Services

  • Critical Access Hospital
  • Bowman, ND
National Provider Identifier
1477529030
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
5006P Issued in 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
Last updated
Feb 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST HEALTH CARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Amanda Loughman
Title
Cfo
Phone
(701) 523-5555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 5006P ND Primary
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 4

IdentifierTypeStateIssuer
012633OtherNDAMBULANCE
01448MedicaidND
000497OtherNDHOSPITAL
1457848MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000689 ND Part A Provider - Critical Access Hospital 3173512704 Receives reassigned benefits from 18 practitioners
Practice locations: Bowman, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477529030. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Mar 1, 2001 in ND
Enrollment address
802 2ND St NW
Bowman, ND 58623-4483
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Southwest Healthcare ServicesCCN 351313 · 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
Southwest Medical Clinic7 organizations share this tax ID, including this one
Part of
Southwest Medical Clinic

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Amanda J Loughman Individual Corporate Officer Nov 5, 2019
Dennis Goebel Individual Corporate Director Oct 15, 2021
Tina Marmon Individual W-2 Managing EmployeeClinic Manager Nov 1, 2011

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 19

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 19

Affiliated clinicians 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1477529030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 2ND ST NW",
            "address_2": "SUITE 1",
            "city": "BOWMAN",
            "state": "ND",
            "postal_code": "58623",
            "telephone_number": "701-523-5555",
            "fax_number": "701-523-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 2ND ST NW",
            "address_2": "SUITE 1",
            "city": "BOWMAN",
            "state": "ND",
            "postal_code": "58623",
            "telephone_number": "701-523-5555",
            "fax_number": "701-523-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEALTHCARE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST HEALTH CARE SERVICES",
        "enumeration_date": "2006-02-24",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "LOUGHMAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-523-5555"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ND",
            "license": "5006P",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMBULANCE",
            "identifier": "012633",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01448",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL",
            "identifier": "000497",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457848",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowman, ND

Sources for this page

Verify at the official NPI Registry.