NPIMap

Organization Active NPI

P R Health Corporation

Doing business as First Care Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Park River, ND
National Provider Identifier
1669568747
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
P R HEALTH CORPORATION
Doing business as
First Care Swing Bed
Practice address
115 Vivian St.
Park River, ND 58270-4540
Phone
(701) 284-7500
Fax
(701) 284-4605
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Louise Dryburgh
Title
Ceo
Phone
(701) 284-7500

Specialties & licenses 1

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

Addresses

Primary practice location

115 Vivian St.
Park River, ND 58270-4540

Mailing address

P O Box I
115 Vivian St.
Park River, ND 58270-0708
Phone (701) 284-7500

Other identifiers 1

IdentifierTypeStateIssuer
001914MedicaidND

Other names 1

  • First Care Swing Bed Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000151 ND Part A Provider - Critical Access Hospital 0840102760 Practice locations: Park River, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669568747. Details of each certification follow.

Hospital certification: CCN 35Z326

Legal name
P R HEALTH CORPORATION
Doing business as
FIRST CARE HEALTH CENTER
Organization structure
CorporationNon-profit
Incorporated
Aug 24, 1950 in ND
Enrollment address
115 Vivian St W
Park River, ND 58270-4540
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
St Ansgars RHC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Katherine Hall Individual Corporate Director Apr 1, 2019
Lori Seim Individual W-2 Managing Employee Jun 3, 2013
Eugene Bossert Individual Corporate Director Apr 1, 2017
Gale Beneda Individual Corporate Director Apr 1, 2017
Nina Hollingsworth Individual W-2 Managing Employee Sep 15, 2022
Loretta Monson Individual Corporate Director Apr 1, 2014
Harold Myrdal Individual Corporate Director Apr 1, 2013
Ann Pohanka Individual Corporate Director Apr 1, 2013
Nicolas D Beneda Individual Corporate Director Apr 1, 2019
Marcus Lewis Individual Corporate OfficerCeo Dec 18, 2017
W-2 Managing EmployeeCeo Dec 18, 2017
Michael Helt Individual Corporate Director Apr 1, 2018
Patty Dahlen Individual Corporate Director Apr 1, 2018
Mark K Helgeson Individual Corporate Director Apr 1, 2015
Dennis Markusen Individual Corporate Director Apr 1, 2015

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
First Care RHCPark River, ND, CCN 353405 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2001

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 2

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 2

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669568747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX I",
            "address_2": "115 VIVIAN ST.",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582700708",
            "telephone_number": "701-284-7500",
            "fax_number": "701-284-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 VIVIAN ST.",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "582704540",
            "telephone_number": "701-284-7500",
            "fax_number": "701-284-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P R HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRYBURGH",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-284-7500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001914",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Care Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park River, ND

Sources for this page

Verify at the official NPI Registry.