Active NPI
Rolette Community Care Center, Inc.
- Skilled Nursing Facility
- Rolette, ND
National Provider Identifier
1497868061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30466 | Medicaid | ND |
Other names 1
- Rolette Community Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 1, 1978
- Medicare certification status
- Active
- Certified beds
- 31
- Special focus status
- SFF Candidate
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D0408690 | Rolette Community Care Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Gary Hill | Corporate Director | Oct 1, 2019 | |
| Kathy Morrow | Corporate Officer | Oct 1, 2006 | |
| W-2 Managing Employee | Oct 1, 2006 | ||
| Cliff Mattson | Corporate Director | 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.
-
- Family Medicine Physician
- Rugby, ND
- NPI 1710052626
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.