Organization Active NPI

Rolette Community Care Center, Inc.

  • Skilled Nursing Facility
  • Rolette, ND
National Provider Identifier
1497868061
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ROLETTE COMMUNITY CARE CENTER, INC.
Practice address
804 State St.
Rolette, ND 58366
Phone
(701) 246-3786
Fax
(701) 246-3422
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Authorized official

Name
Kathy Morrow
Title
Cfo
Phone
(701) 246-3786

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X ND
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

804 State St.
Rolette, ND 58366

Mailing address

804 State St.
Rolette, ND 58366
Phone (701) 246-3786

Other identifiers 1

IdentifierTypeStateIssuer
30466MedicaidND

Other names 1

  • Rolette Community Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061020000543 ND Part A Provider - Skilled Nursing Facility 4789681487 Practice locations: Rolette, ND

Skilled nursing facility certification: CCN 355081

Legal name
ROLETTE COMMUNITY CARE CENTER INC
Doing business as
ROLETTE COMMUNITY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1978
Last certification
Sep 19, 2024
Beds
31
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2006 in ND
Enrollment address
804 State St
Rolette, ND 58366-7101
Nursing home name
ROLETTE COMMUNITY CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rolette Community Care CenterCCN 355081
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3120.7 residents per day on average
Special focus status
SFF Candidate
Penalties (3 years)
3Fines totaling $90,017

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0408690Rolette Community Care Center804 State St, Rolette, ND 58366Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Gary Hill Individual Corporate DirectorBoard Chair Oct 1, 2019
Kathy Morrow Individual Corporate OfficerCfo Oct 1, 2006
W-2 Managing Employee Oct 1, 2006
Cliff Mattson Individual Corporate DirectorVice President Apr 21, 2021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1497868061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 STATE ST.",
            "city": "ROLETTE",
            "state": "ND",
            "postal_code": "58366",
            "telephone_number": "701-246-3786",
            "fax_number": "701-246-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 STATE ST.",
            "city": "ROLETTE",
            "state": "ND",
            "postal_code": "58366",
            "telephone_number": "701-246-3786",
            "fax_number": "701-246-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLETTE COMMUNITY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701-246-3786"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30466",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolette Community Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rolette Community Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolette, ND

Sources for this page

Verify at the official NPI Registry.