NPIMap

Organization Active NPI

Lutheran Charity Association

Doing business as Jamestown Regional Medical Center Home Health Agency

  • Home Health Agency
  • Jamestown, ND
National Provider Identifier
1528052511
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
4020A Issued in ND
Legal business name
LUTHERAN CHARITY ASSOCIATION
Doing business as
Jamestown Regional Medical Center Home Health Agency
Practice address
2422 20TH St SW
Jamestown, ND 58401-6201
Phone
(701) 252-1050
Fax
(701) 952-3265
NPI assigned
Sep 6, 2005
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Mr. Michael J Delfs
Title
Chief Executive Officer
Phone
(701) 952-4850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 4020A ND Primary

Addresses

Primary practice location

2422 20TH St SW
Jamestown, ND 58401-6201

Mailing address

2422 20TH St SW
Jamestown, ND 58401-6201
Phone (701) 952-4847

Other identifiers 1

IdentifierTypeStateIssuer
1452365MedicaidND

Other names 1

  • Jamestown Regional Medical Center Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030519000003 ND Part A Provider - Home Health Agency 2264341031 Practice locations: Jamestown, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528052511. Details of each certification follow.

Home health agency certification: CCN 357002

Legal name
LUTHERAN CHARITY ASSOCIATION
Doing business as
JAMESTOWN REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Aug 17, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
May 27, 1927 in ND
Enrollment address
2422 20TH St SW
Jamestown, ND 58401-6201

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jamestown Regional Medical Center Home HealthCCN 357002 · All quality measures
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Jamestown Reg Med CNTR7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jeremy Robert Rham Individual Corporate Director Nov 1, 2022
Casey Henderson Individual Corporate Officer Mar 1, 2016
Compeer Financial Organization, Sun Prairie, WI 5% Or Greater Mortgage Interest Mar 21, 2010 21%
Amanda Kelly Thrift Individual Corporate Director Nov 1, 2022
Holly June Cherlynn Utke Individual Corporate DirectorBoard Member Nov 1, 2025
Michael J Delfs Individual Corporate OfficerPresident and Ceo Mar 1, 2019
W-2 Managing EmployeeAd; Mar 1, 2019
Clemens Jack Hager Individual Corporate OfficerBoard Member Nov 1, 2024
Usda Department of Agriculture Rural Development Organization, Bismarck, ND 5% Or Greater Mortgage Interest Mar 24, 2010 43%
Tania Falk Individual Corporate Director Nov 1, 2023
Timothy Burchill Individual Corporate Director Mar 1, 2021
Derek J Schaff Individual Corporate OfficerVice President and Cfo Oct 1, 2025
W-2 Managing EmployeeAd; Oct 1, 2025
Sean Jordan Rinkenberger Individual Corporate OfficerBoard Member Nov 1, 2024
Briana Bohn Individual Corporate Director Nov 1, 2022
Steven Timothy Ottmar Individual Corporate Director Nov 1, 2019
Randall Lee Jaspers Individual Corporate Director Nov 1, 2019
Trisha Jungels Individual Corporate OfficerVice President and Cno Apr 15, 2013
W-2 Managing EmployeeAd; Apr 15, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jamestown Regional Medical CenterJamestown, ND, CCN 35Z335 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1528052511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-952-4847",
            "fax_number": "701-952-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584016201",
            "telephone_number": "701-252-1050",
            "fax_number": "701-952-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN CHARITY ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "DELFS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "701-952-4850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ND",
            "license": "4020A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452365",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamestown Regional Medical Center Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jamestown Regional Medical Center Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.