Culbertson Froid Bainville Health Care Corporation
Organization Active NPI Critical Access Hospital · Culbertson, MT
NPI 1598874232 · NPPES record last updated Dec 18, 2019
Key facts
- NPI
- 1598874232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 10739 (MT)
- Legal business name
- CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION
- Practice address
- 818 2ND Ave E
Culbertson, MT 59218-9363 - Phone
- (406) 787-6401
- Fax
- (406) 787-6289
- NPI assigned
- Aug 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Audrey Stromberg
- Title
- Administrator
- Phone
- (406) 787-6401
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 2
Practitioners 18
-
Zoe Elaine Fugere, FNP-C
-
Elizabeth Ellen Kleppen, RN, PA-C
-
Carlos F Trevino, MD, PC
-
Blaine G White, PA-C
-
Siavash David Shahbodaghi, MD/MPH
-
Lesa Colleen Whitehead, NP-C
-
Patricia Alderson, FNP
-
Stephanie L Catron, FNP
-
Jessica Marie Domire, APRN
-
Adam W Graham, P.A.
-
Lynn Marie Graham, MS PT, PA-C MPAS
-
Brenda Dawn Koessl, FNP-C
-
Mike Douglas Berry, FNP
-
Brady Scott Ruff, P.A. - C
Affiliated clinicians 11
-
Aaron John Franke, M.D.
-
Zoe Elaine Fugere, FNP-C
-
Elizabeth Ellen Kleppen, RN, PA-C
-
Alyssa Severson, PA-C
-
Carlos F Trevino, MD, PC
-
Blaine G White, PA-C
-
Kami L Winnicki, FNP
-
Tyler Baldwin, MD
-
Paul Wayne Rigsby, D.O.
-
Lesa Colleen Whitehead, NP-C
Medicare Care Compare: Hospital
- Listed as
- Roosevelt Medical Center
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT
Hospital certification: CCN 271308
- Legal name
- CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION
- Doing business as
- ROOSEVELT MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 1, 1999
- Last certification
- Sep 15, 2021
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1976 in MT
- Enrollment address
- 818 2ND Ave E
Culbertson, MT 59218-9363
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Steven Larsen |
Corporate Director |
May 1, 2022 | 11% |
| Elizabeth Leinen |
W-2 Managing Employee |
Sep 1, 2009 | 100% |
| Kathleen Thompson |
Corporate Director |
Jan 1, 2025 | |
| Russell Bowker |
Corporate Director |
Jun 1, 2023 | 11% |
| Scott Roth |
Corporate Director |
Jun 1, 2023 | 11% |
| Sharon Schmitz |
Corporate Director |
May 31, 2015 | 9% |
| Wesley Steppler |
Corporate Director |
Jun 1, 2023 | 11% |
| Jamason Schmidt |
Corporate Officer |
Aug 12, 2024 | |
| Troy Green |
Corporate Director |
Jun 1, 2024 | 11% |
| Cassandra Bergum |
Corporate Director |
May 1, 2022 | 11% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000761 | MT | Part B Supplier - Clinic/Group Practice | 3173425436 |
Receives reassigned benefits from 18 practitioners Practice locations: Culbertson, MT |
| O20061104000663 | MT | Part a Provider - Critical Access Hospital | 3173425436 | Practice locations: Culbertson, MT |
National Provider Directory
Locations
818 2nd Ave E
Culbertson, MT 59218
Phone (406) 787-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 10739 | MT | Yes |
| Land Ambulance | 3416L0300X | 42 | MT | |
| Non-emergency Medical Transport (VAN) | 343900000X | MT |
Addresses
Primary practice location
818 2ND Ave E
Culbertson, MT 59218-9363
Mailing address
PO Box 419
Culbertson, MT 59218-0419
Phone (406) 787-6401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000009968 | Other | MT | CAH MEDICARE PART B |
| MSF0058616 | Other | MT | MONTANA STATE FUND |
| 0000001182 | Other | MT | BLUE CROSS BLUE SHIELD |
| 4106531 | Medicaid | MT | |
| 442741 | Other | MT | MEDICAID - AMBULANCE |
| 0520472 | Other | MT | MEDICAID TRANSPORT NON-EM |
Other names
- Roosevelt Medical Center
- Roosevelt Memorial Medical Center
Other providers in Culbertson, MT
- 406 RX PLLC
- 406 RX, PLLC
- Culbertson Froid Bainville Health Care Corporation
- Culbertson Froid Bainville Healthcare Corporation
- Culbertson Froid Bainville Healthcare Corporation
- Culbertson Pharmacy Inc
- Don Helland
- Jocelyn Marie Klein
All providers in Culbertson, MT · Critical Access Hospital in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.