NPIMap

Organization Active NPI

Bowdle Hospital

  • Critical Access Hospital
  • Bowdle, SD
National Provider Identifier
1669418877
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
10527 Issued in SD
Legal business name
BOWDLE HOSPITAL
Practice address
8001 West 5TH Street
Bowdle, SD 57428-0556
Phone
(605) 285-6146
Fax
(605) 285-6410
NPI assigned
Jun 22, 2006
Last updated
Aug 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Authorized official

Name
Mr. Jon Kosiak
Title
Ceo
Phone
(605) 285-6146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 10527 SD Primary

Addresses

Primary practice location

8001 West 5TH Street
Bowdle, SD 57428-0556

Mailing address

PO Box 556
Bowdle, SD 57428-0556
Phone (605) 285-6146

Other identifiers 6

IdentifierTypeStateIssuer
9566070MedicaidSD
5500670MedicaidSD
80079OtherSDBLUE CROSS
9002440MedicaidSD
0100670MedicaidSD
5405070MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325001225 SD Part B Supplier - Clinic/Group Practice 9335056902 Receives reassigned benefits from 6 practitioners
4 other NPIs on this enrollment
Practice locations: Bowdle, SD
O20070208000330 SD Part A Provider - Critical Access Hospital 9335056902 Receives reassigned benefits from 6 practitioners
Practice locations: Bowdle, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669418877. Details of each certification follow.

Hospital certification: CCN 431318

Legal name
BOWDLE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2001
Last certification
Jul 6, 2022
Beds
12
Ownership / control type
Local
Organization structure
CorporationNon-profit
Incorporated
Dec 22, 2003 in SD
Enrollment address
8001 W 5TH St
Bowdle, SD 57428-2031
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Bowdle Hospital - CahCCN 431318 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Bowdle Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
City of Bowdle Organization, Bowdle, SD 5% Or Greater Direct Ownership Interest Feb 1, 1987
Operational/Managerial Control Feb 1, 1987
Gary Frankfurth Individual Corporate DirectorAlderman Mar 6, 2017
Erick Bieber Individual Corporate Director May 4, 2015 100%
Darwyn Kleffman Individual Corporate OfficerCeo Oct 8, 2019
W-2 Managing EmployeeCeo Oct 8, 2019
Michael Gunderson Individual Corporate DirectorAlderman May 1, 2017
Rick Boschee Individual Corporate DirectorChairperson May 1, 2009
Daniel Hardison Individual Corporate DirectorAlderman Jul 1, 2020
Rex Gab Individual Corporate DirectorAlderman May 1, 2016

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1669418877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 556",
            "city": "BOWDLE",
            "state": "SD",
            "postal_code": "574280556",
            "telephone_number": "605-285-6146",
            "fax_number": "605-285-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 WEST 5TH STREET",
            "city": "BOWDLE",
            "state": "SD",
            "postal_code": "574280556",
            "telephone_number": "605-285-6146",
            "fax_number": "605-285-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWDLE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "KOSIAK",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-285-6146",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "SD",
            "license": "10527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9566070",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5500670",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "80079",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9002440",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100670",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5405070",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowdle, SD

Sources for this page

Verify at the official NPI Registry.