Cavalier County Memorial Hospital Association
Organization Active NPI Rural Health Clinic/Center · Walhalla, ND
NPI 1497815310 · NPPES record last updated Jun 30, 2026
Key facts
- NPI
- 1497815310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 5029 (ND)
- Legal business name
- CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION
- Practice address
- 301 5TH St
Walhalla, ND 58282-4625 - Phone
- (701) 549-2711
- NPI assigned
- Dec 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CAVALIER COUNTY MEMORIAL HOSPITAL ASSOC
Authorized official
- Name
- Mr. Todd Christensen
- Title
- Interim Ceo
- Phone
- (701) 256-6180
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Practitioners 12
-
Emeka S Okwudili, MD
-
Megan Overby, FNP-C
-
Courtney Short, FNP
-
Elizabeth M Sillers, FNP
-
Emily A Balsdon, FNP-C
-
Rory Ratzlaff, MD
-
William Logan Bender, M.D.
-
Daniel Hagerty, NP
-
Joshua Hughes, PA-C
-
Dean Thomas Langenfeld, M.D.
-
David T Rothwell, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D0926057 | Walhalla Clinic | Certificate of waiver | Sep 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Rural health clinic certification: CCN 353458
- Legal name
- CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION
- Doing business as
- WALHALLA CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Feb 16, 2016
- Last certification
- Jun 27, 2023
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 1, 1979 in ND
- Enrollment address
- 301 5TH St
Walhalla, ND 58282-4625 - Related CCNs
- 351323
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Runa C Anderson |
Corporate Director |
Nov 18, 2020 | |
| Darla J Roder |
Corporate Officer |
Jan 15, 2016 | |
| Richard Wayne Reid |
Corporate Officer |
Oct 16, 2023 | |
| W-2 Managing Employee |
Oct 16, 2023 | ||
| Sarah R Mikkelsen |
W-2 Managing Employee | Oct 12, 2020 | |
| Kathryn M Kopf |
Corporate Director |
Nov 20, 2019 | |
| Sherry Buchweitz |
Corporate Director |
Nov 21, 2021 | |
| Other | Nov 21, 2021 | ||
| Steven Hart |
Corporate Director |
Jul 5, 2022 | |
| Other | Jul 5, 2022 | ||
| Jackie Dvorak |
Corporate Director |
Mar 1, 2024 | |
| Other | Mar 1, 2024 | ||
| Chyrisse Regehr |
Corporate Director |
Dec 1, 2022 | |
| Other | Dec 1, 2022 | ||
| Jay Dubois |
Corporate Director |
Nov 16, 2016 | |
| Michelle Skillings |
Corporate Officer |
Mar 27, 2023 | |
| W-2 Managing Employee |
Mar 27, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120117000605 | ND | Part a Provider - Rural Health Clinic | 5092623520 | Practice locations: Walhalla, ND |
National Provider Directory
- Tax ID family
- Langdon Ambulance
- Part of
- Langdon Ambulance
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 5029 | ND | Yes |
Addresses
Primary practice location
301 5TH St
Walhalla, ND 58282-4625
Mailing address
909 2ND St
Langdon, ND 58249-2407
Phone (701) 256-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1470144 | Medicaid | ND |
Other names
- Langdon Prairie Hospital
- Cavalier County Memorial Hosptial - Walhalla Clinic
Other providers in Walhalla, ND
- Beverly J Clairmont
- Spencer E Clairmont
- Richard Nicholas Colon
- Sharon Lynn Heidler
- Karla N Parkes, PLLC
All providers in Walhalla, 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 30, 2026. 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.