NPIMap

Organization Active NPI

St. John's Lutheran Hospital, Inc.

Doing business as Cabinet Peaks Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Libby, MT
National Provider Identifier
1588720882
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
11971 Issued in MT
Legal business name
ST. JOHN'S LUTHERAN HOSPITAL, INC.
Doing business as
Cabinet Peaks Medical Center
Practice address
209 Health Park Dr
Libby, MT 59923-2001
Phone
(406) 283-7000
Fax
(406) 293-3895
NPI assigned
Dec 29, 2006
Last updated
Mar 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Julie L Leonard
Title
Cfo
Phone
(406) 283-7219

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 10828 MT
Medicare Defined Swing Bed Hospital Unit 275N00000X 11971 MT Primary

Addresses

Primary practice location

209 Health Park Dr
Libby, MT 59923-2001

Mailing address

209 Health Park Dr
Libby, MT 59923-2001
Phone (406) 283-7000

Other identifiers 1

IdentifierTypeStateIssuer
3100006MedicaidMT

Other names 1

  • Cabinet Peaks 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
O20120709000599 MT Part A Provider - Critical Access Hospital 1557255676 Practice locations: Libby, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588720882. Details of each certification follow.

Hospital certification: CCN 27Z320

Legal name
ST JOHNS LUTHERAN HOSPITAL INC
Doing business as
CABINET PEAKS MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1944 in MT
Enrollment address
209 Health Park Dr
Libby, MT 59923-2001

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Kootenai Internal Medic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Steven L Sorensen Individual Corporate DirectorBoard Member Jul 5, 1994
Daniel Rose Individual Corporate DirectorBoard Member Jan 3, 2023
Darren Brockie Individual Corporate DirectorBoard Member Jan 3, 2023
Kerry Beasley Individual Corporate DirectorBoard Member Apr 4, 1995
Tadd S Greenfield Individual Corporate OfficerCeo Feb 14, 2023
Kathleen Nelson Individual Corporate DirectorBoard Member Sep 2, 2007
Lancaster Pollard Holdings, LLC Organization, Dallas, TX Financial institution 5% Or Greater Mortgage Interest Sep 28, 2012 25.4%
Manuel Robert Castaneda Individual Corporate DirectorBoard Member Sep 2, 2008
Julie L Leonard Individual Corporate OfficerCfo Jan 6, 2024
Sarah E Sorensen Individual Corporate DirectorBoard Member Nov 2, 2010
Autumn Smith Individual W-2 Managing EmployeeRCM May 1, 2022

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 153

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 153

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1588720882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 HEALTH PARK DR",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232001",
            "telephone_number": "406-283-7000",
            "fax_number": "406-293-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HEALTH PARK DR",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232001",
            "telephone_number": "406-283-7000",
            "fax_number": "406-293-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S LUTHERAN HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-283-7219"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MT",
            "license": "10828",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MT",
            "license": "11971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100006",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cabinet Peaks Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cabinet Peaks Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libby, MT

Sources for this page

Verify at the official NPI Registry.