Frances Mahon Deaconess Hospital
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Glasgow, MT
NPI 1487768974 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1487768974
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 10542 (MT)
- Legal business name
- FRANCES MAHON DEACONESS HOSPITAL
- Practice address
- 621 3Rd St S
Glasgow, MT 59230-2604 - Phone
- (406) 228-3500
- Fax
- (406) 228-3680
- NPI assigned
- Aug 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cami Kalinski
- Title
- Director of Financial Services
- Phone
- (406) 228-3500
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 2
Related certifications (CCN) 1
Practitioners 38
-
Jace Allen Ball, PA-C
-
Lisa Elaine Ball, CRNA
-
Kristina Bengochea, LCPC
-
Tyson Cochran, MD
-
Andrew Fahlgren, MD
-
Kyle Jeffrey Gibson, APRN
-
Chelsea Headley, PA-C
-
Mark Andrew Hiesterman, D.O.
-
Amy Hopstad, MD
-
David Arthur Knierim, M.D.
-
James Alton Martin, PH.D.
-
Brean Drew McCarthy, D.O.
-
Anne M Millard, M.D.
-
Nicole Nelson, PA
-
Kevin Allen Ross, MD
-
Emily M Stevenson, PA-C
-
Jeremy John Stringer, DNP CRNA
-
Gaye Lynn Stulc, FNP-C
-
Haylee Thompson, FNP
Affiliated clinicians 5
-
David Arthur Knierim, M.D.
-
Anne M Millard, M.D.
-
Kevin Allen Ross, MD
-
Marie A Dominguez, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Hospital certification: CCN 27Z316
- Legal name
- FRANCES MAHON DEACONESS HOSPITAL
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 20, 1914 in MT
- Enrollment address
- 621 3Rd St S
Glasgow, MT 59230-2604
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Angela Page |
Corporate Director | Jul 1, 2025 | |
| Nichole Bergtoll |
Corporate Director | Jul 1, 2025 | |
| Camilia Kalinski |
W-2 Managing Employee |
Oct 28, 2002 | |
| Brianne Capdeville |
Corporate Director | Jul 1, 2020 | |
| Dirk Markle |
Corporate Director | Jul 1, 2024 | |
| Connie Brunelle |
W-2 Managing Employee | Feb 1, 2015 | |
| Susan Johnson |
W-2 Managing Employee | Nov 1, 2019 | |
| Gordon L Bell |
Corporate Director | Jul 1, 2023 | |
| Nickolas Dirkes |
Corporate Officer | Oct 1, 2022 | |
| W-2 Managing Employee |
Oct 1, 2022 | ||
| Cami Graham |
Corporate Director | Jul 1, 2021 | |
| Marisa Sather |
Corporate Director | Jan 29, 2020 | |
| Stanley Ozark |
Corporate Director | Nov 29, 2017 | |
| Patrick Menge |
Corporate Director | Nov 29, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071002000082 | MT | Part a Provider - Critical Access Hospital | 3173430949 | Practice locations: Glasgow, MT |
National Provider Directory
- Tax ID family
- Lawrence D Bockar MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 10542 | MT | Yes |
Addresses
Primary practice location
621 3Rd St S
Glasgow, MT 59230-2604
Mailing address
621 3Rd St S
Glasgow, MT 59230-2604
Phone (406) 228-3500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3100461 | Medicaid | MT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | FMDH@direct-address.net | Direct |
Other providers in Glasgow, MT
- Michael J Fay
- Gerry Eugene Fink
- Frances Mahon Deaconess Hospital
- Frances Mahon Deaconess Hospital
- Frances Mahon Deaconess Hospital
- Frances Mahon Deaconess Hospital
- Frances Mahon Deaconess Hospital
- Jack Michael Gasky
- Kyle Jeffrey Gibson
- Glasgow Clinic, Inc.
All providers in Glasgow, MT · Medicare Defined Swing Bed Hospital Unit in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.