NPIMap

Organization Active NPI

Lutheran Charity Association

Doing business as Jamestown Regional Medical Center

  • Critical Access Hospital
  • Jamestown, ND
National Provider Identifier
1548256753
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
5027A Issued in ND
Legal business name
LUTHERAN CHARITY ASSOCIATION
Doing business as
Jamestown Regional Medical Center
Practice address
2422 20TH St SW
Jamestown, ND 58401-6201
Phone
(701) 252-1050
Fax
(701) 952-3265
NPI assigned
Sep 22, 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
Critical Access Hospital 282NC0060X 5027A 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) 252-1050

Other identifiers 1

IdentifierTypeStateIssuer
1452345MedicaidND

Other names 1

  • Jamestown Regional Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000530 ND Part A Provider - Critical Access Hospital 2264341031 Receives reassigned benefits from 72 practitioners
Practice locations: Jamestown, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548256753. Details of each certification follow.

Hospital certification: CCN 351335

Legal name
LUTHERAN CHARITY ASSOCIATION
Doing business as
JAMESTOWN REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 2009
Last certification
Nov 9, 2016
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 27, 1927 in ND
Enrollment address
2422 20TH St SW
Jamestown, ND 58401-6201
Other Hospital Practice Location

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

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: Hospital

Medicare Care Compare
Listed as
Jamestown Regional Medical CenterCCN 351335 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

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 DirectorBoard Member Mar 1, 2016
Compeer Financial Organization, Sun Prairie, WI 5% Or Greater Mortgage Interest Mar 25, 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 DirectorBoard Member 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 Officer Nov 1, 2019
Trisha Jungels Individual Corporate OfficerCno Apr 15, 2013
W-2 Managing EmployeeVP of Clinical Services 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

Practitioners 84

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.

View all 84

Affiliated clinicians 148

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

View all 148

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1548256753",
    "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": "701-252-1050",
            "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": "2005-09-22",
        "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ND",
            "license": "5027A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452345",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamestown Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jamestown Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.