Mercy Hospital of Valley City
Organization Active NPI Critical Access Hospital · Valley City, ND
NPI 1477549111 · NPPES record last updated Jun 23, 2017
Key facts
- NPI
- 1477549111
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 5050A (ND)
- Legal business name
- MERCY HOSPITAL OF VALLEY CITY
- Practice address
- 570 Chautauqua Blvd
Valley City, ND 58072-3145 - Phone
- (701) 845-6400
- Fax
- (701) 845-6413
- NPI assigned
- Sep 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Keith Heuser
- Title
- Administrator
- Phone
- (701) 845-6400
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Practitioners 86
-
Clark J Kruta, CRNA
-
Kelli Lynn McAllister, FNP-BC
-
Ricardy Rimpel, M.D
-
Misty Kay Anderson, D.O.
-
Heidi L Andruski, CRNA
-
Trent William Bitz, FNP-C
-
James B Buhr, MD
-
Tanya L Diegel, DO
-
Alain Mathew Green, MSN, APRN, FNP-C
-
Michael L Hammer, DNP
-
Ron L Honeyman, CRNA
-
Mark W Klabo, PA-C
-
Randy L Kremer, CRNA
-
Madeline Z Luke, MD
-
Debra L. Middleton, FNP
-
Tara M Nardacci, N.P.
Affiliated clinicians 71
-
Judy L Anderson, PA-C
-
Misty Kay Anderson, D.O.
-
Jason Balvitsch, PA-C
-
Scott M. Belliston, D.O.
-
Trent William Bitz, FNP-C
-
Derek M Brickner, MD
-
Rachael Burns, PA-C
-
Brian K Dees, MD
-
Tanya L Diegel, DO
-
Shara J Diers, PA
-
Haley Fisher, DNP
-
Teresa D Formo, APRN, CNP
-
Anna Paige Fuka, PA-C
-
Mahendra K Gupta, MD
-
Michael L Hammer, DNP
Medicare Care Compare: Hospital
- Listed as
- CHI Mercy Health
- Overall star rating
- ★★★★★ 5 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ND
Hospital certification: CCN 351324
- Legal name
- MERCY HOSPITAL OF VALLEY CITY
- Doing business as
- CHI MERCY HEALTH
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2002
- Last certification
- Mar 1, 2023
- Beds
- 25
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 14, 1928 in ND
- Enrollment address
- 570 Chautauqua Blvd
Valley City, ND 58072-3145
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Commonspirit Health |
5% Or Greater Direct Ownership Interest | Apr 30, 1996 | |
| Lloyd H Dean |
Corporate Officer |
Jun 1, 2000 | |
| Fredrick Mitzel |
Corporate Director |
Jul 1, 2020 | |
| Amber G Stowman |
Corporate Officer |
Aug 12, 2018 | |
| W-2 Managing Employee |
Aug 12, 2018 | ||
| Casey Stoudt |
Corporate Director |
Jan 1, 2017 | |
| Page Bjornson |
Corporate Director |
Jul 1, 2019 | |
| Alan Lafave |
Corporate Director |
Jul 1, 2019 | |
| Bethany K Smith |
Corporate Officer |
Jul 1, 2009 | |
| W-2 Managing Employee |
Jul 1, 2009 | ||
| Rebecca Thompson |
Corporate Officer |
Jul 15, 2021 | |
| W-2 Managing Employee |
Jul 15, 2021 | ||
| Tim Ost |
Corporate Director |
Jul 1, 2020 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| CHI Mercy Health |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jun 12, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040701000086 | ND | Part B Supplier - Clinic/Group Practice | 8729997564 |
Receives reassigned benefits from 81 practitioners 1 other NPI on this enrollment Practice locations: Valley City, ND |
| O20070611000170 | ND | Part a Provider - Critical Access Hospital | 8729997564 |
Receives reassigned benefits from 44 practitioners Practice locations: Valley City, ND |
National Provider Directory
- Tax ID family
- Mercy Hospital of Valley City
Locations
570 Chautauqua Blvd
Valley City, ND 58072
Phone (701) 845-0440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | |||
| Critical Access Hospital Clinic/Center | 261QC0050X | 5050 | ND | |
| Critical Access Hospital | 282NC0060X | 5050A | ND | Yes |
Addresses
Primary practice location
570 Chautauqua Blvd
Valley City, ND 58072-3145
Mailing address
570 Chautauqua Blvd
Valley City, ND 58072-3145
Phone (701) 845-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5050A | Other | ND | HOSPITAL LICENSE |
| 001056 | Medicaid | ND | |
| 20388 | Medicaid | ND |
Other names
- CHI MERCY HEALTH
Other providers in Valley City, ND
- Scott McNeal
- Mercy Hospital
- Mercy Hospital
- Mercy Hospital
- Mercy Hospital
- Mercy Hospital of Valley City
- Mercy Hospital of Valley City
- Kenneth W Merkes
- Fredrick Mitzel
- Mobilityplus Rehabilitation, LTD
All providers in Valley City, 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 Jun 23, 2017. 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.