Immanuel Lutheran Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10077 Issued in MT

Legal business name

IMMANUEL LUTHERAN CORPORATION

Doing business as

Immanuel Lutheran Home

Practice address

185 Crestline Ave
Kalispell, MT 59901-3573

Phone

(406) 752-9622

Fax

(406) 752-9615

NPI assigned

Jul 18, 2005

Last updated

Dec 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Keith Gendreau, LNHA CEO,CALA, FELLO

Title

Adminstrator.Ceo

Phone

(406) 752-9622

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Immanuel Lutheran Home Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649279183. Details of each certification follow.

• CCN 275129 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 275129

Legal name

IMMANUEL LUTHERAN CORPORATION

Doing business as

IMMANUEL SKILLED CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 1, 1989

Last certification

Oct 24, 2024

Beds

155

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 17, 1953 in MT

Enrollment address

185 Crestline Ave
Kalispell, MT 59901-3573

Nursing home name

IMMANUEL SKILLED CARE CENTER

Listed as

Immanuel Skilled Care CenterCCN 275129 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Sep 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

155106.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Partners in Home Care, Inc

  • Community Based Hospice Care Agency
  • Missoula, MT
  • NPI 1992862718

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 3

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

• David Habel, M.D.

  • Internal Medicine Physician
  • Kalispell, MT
  • NPI 1992747927

  Managing Control - Governing Body, Trustee of the SNF

  CMS ownership
• Douglas Nelson, M.D.

  • Internal Medicine Physician
  • Kalispell, MT
  • NPI 1427091065

  Managing Control - Governing Body, Trustee of the SNF

  CMS ownership
• Martin Schiffert, MD

  • Family Medicine Physician
  • Billings, MT
  • NPI 1609819259

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 4

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.

• Derek Allan Gedlaman, DO

  • Family Medicine Physician
  • Columbia Falls, MT
  • NPI 1902895329
  NPD (past)
• Jason Leep, MD

  • Family Medicine Physician
  • Whitefish, MT
  • NPI 1811125818
  NPD (past)
• Martin Schiffert, MD

  • Family Medicine Physician
  • Billings, MT
  • NPI 1609819259
  NPD (past)
• Anne Christine Zender-Princeton, D.O.

  • Occupational Medicine Physician
  • Great Falls, MT
  • NPI 1114288115
  NPD (past)

Affiliated clinicians 5

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

• Laura Jo Barker, PA-C, RD

  • Physician Assistant
  • Kalispell, MT
  • NPI 1720058365

  Nursing home

  Care Compare affiliation
• Derek Allan Gedlaman, DO

  • Family Medicine Physician
  • Columbia Falls, MT
  • NPI 1902895329

  Nursing home

  Care Compare affiliation
• Jason Leep, MD

  • Family Medicine Physician
  • Whitefish, MT
  • NPI 1811125818

  Nursing home

  Care Compare affiliation
• Justin Shobe

  • Physician Assistant
  • Kalispell, MT
  • NPI 1164814836

  Nursing home

  Care Compare affiliation
• Anne Christine Zender-Princeton, D.O.

  • Occupational Medicine Physician
  • Great Falls, MT
  • NPI 1114288115

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1649279183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 CRESTLINE AVE",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013573",
            "telephone_number": "406-752-9622",
            "fax_number": "406-752-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 CRESTLINE AVE",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013573",
            "telephone_number": "406-752-9622",
            "fax_number": "406-752-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL LUTHERAN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "GENDREAU",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "ADMINSTRATOR.CEO",
        "authorized_official_telephone_number": "406-752-9622",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA CEO,CALA, FELLO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MT",
            "license": "10077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40632",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0313300",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0348023",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347815",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0534430",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Immanuel Lutheran Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Skilled Nursing Facility in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.

Verify at the official NPI Registry.