NPIMap

Organization Active NPI

Culbertson Froid Bainville Health Care Corporation

Doing business as Roosevelt Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Culbertson, MT
National Provider Identifier
1497865026
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
10739 Issued in MT
Legal business name
CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION
Doing business as
Roosevelt Medical Center
Roosevelt Memorial Medical Center
Practice address
818 2ND Ave E
Culbertson, MT 59218-9363
Phone
(406) 787-6401
Fax
(406) 787-6289
NPI assigned
Aug 30, 2006
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Audrey Stromberg
Title
Administrator
Phone
(406) 787-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 10739 MT Primary

Addresses

Primary practice location

818 2ND Ave E
Culbertson, MT 59218-9363

Mailing address

PO Box 419
Culbertson, MT 59218-0419
Phone (406) 787-6401

Other names 2

  • Roosevelt Medical Center Doing business as
  • Roosevelt Memorial Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071001000187 MT Part A Provider - Critical Access Hospital 3173425436 Practice locations: Culbertson, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497865026. Details of each certification follow.

Hospital certification: CCN 27Z308

Legal name
CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION
Doing business as
ROOSEVELT MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1976 in MT
Enrollment address
818 2ND Ave E
Culbertson, MT 59218-9363
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Roosevelt Mem HSP HSG2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Steven Larsen Individual Corporate OfficerBoard Director - Trustee May 1, 2022 11%
Elizabeth Leinen Individual W-2 Managing EmployeeBusiness Office Manager Sep 1, 2009 100%
Kathleen Thompson Individual Corporate OfficerBoard Director - Trustee May 1, 2020 11%
Russell Bowker Individual Corporate DirectorBoard Director Jun 1, 2023 11%
Scott Roth Individual Corporate DirectorBoard Director Jun 1, 2023 11%
Sharon Schmitz Individual Corporate DirectorBoard Director - Trustee May 1, 2015 11%
Wesley Steppler Individual Corporate DirectorBoard Director Jun 1, 2023 11%
Jamason Schmidt Individual Corporate OfficerChief Executive Officer Aug 12, 2024
Troy Green Individual Corporate DirectorBoard Director Jun 1, 2024 11%
Cassandra Bergum Individual Corporate DirectorBoard Director - Trustee May 1, 2022 11%

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1497865026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "CULBERTSON",
            "state": "MT",
            "postal_code": "592180419",
            "telephone_number": "406-787-6401",
            "fax_number": "406-787-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 2ND AVE E",
            "city": "CULBERTSON",
            "state": "MT",
            "postal_code": "592189363",
            "telephone_number": "406-787-6401",
            "fax_number": "406-787-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "STROMBERG",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "406-787-6401"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MT",
            "license": "10739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roosevelt Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roosevelt Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Culbertson, MT

Sources for this page

Verify at the official NPI Registry.