NPIMap

Organization Active NPI

West River Health Services

Doing business as Bowman Clinic

  • Rural Health Clinic/Center
  • Bowman, ND
National Provider Identifier
1497856025
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WEST RIVER HEALTH SERVICES
Doing business as
Bowman Clinic
Practice address
608 Highway 12 W
Bowman, ND 58623-4507
Phone
(701) 523-3271
Fax
(701) 523-5593
NPI assigned
Sep 26, 2006
Last updated
May 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Mr. James Long
Title
Ceo
Phone
(701) 567-6184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

608 Highway 12 W
Bowman, ND 58623-4507

Mailing address

1000 Highway 12
Hettinger, ND 58639-7530
Phone (701) 567-4561

Other identifiers 2

IdentifierTypeStateIssuer
000005015MedicaidND
53440012MedicaidSD

Other names 1

  • Bowman Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20020813000023 ND Part A Provider - Rural Health Clinic 0042127045 Practice locations: Bowman, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497856025. Details of each certification follow.

Rural health clinic certification: CCN 353982

Legal name
WEST RIVER HEALTH SERVICES
Doing business as
BOWMAN CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 20, 1991
Last certification
Oct 3, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 6, 1977 in ND
Enrollment address
608 Highway 12 West
Bowman, ND 58623-4507
Related CCNs
351330

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Hettingerwr Health Cli10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

683 State Ave
Ste E
Dickinson, ND 58601
Phone (701) 483-4561

409 Main Ave
Lemmon, SD 57638

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kurt Sargent Individual Corporate OfficerChief Financial Officer Nov 3, 2025
W-2 Managing EmployeeChief Financial Officer Nov 3, 2025
Alyson Freeland Individual Corporate OfficerChief Executive Officer Oct 3, 2022
W-2 Managing EmployeeAd; Oct 3, 2022
Cody Jorgenson Individual Corporate Director Sep 15, 2013
Jonathon Eaton Individual Corporate Director Sep 15, 2014

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1497856025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397530",
            "telephone_number": "701-567-4561",
            "fax_number": "701-567-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 HIGHWAY 12 W",
            "city": "BOWMAN",
            "state": "ND",
            "postal_code": "586234507",
            "telephone_number": "701-523-3271",
            "fax_number": "701-523-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST RIVER HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-567-6184",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000005015",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53440012",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bowman Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowman, ND

Sources for this page

Verify at the official NPI Registry.