NPIMap

Organization Active NPI

P R Health Corporation

Doing business as First Care Health Center

  • Critical Access Hospital
  • Park River, ND
National Provider Identifier
1679669741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
5042P Issued in ND
Legal business name
P R HEALTH CORPORATION
Doing business as
First Care Health Center
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
Critical Access Hospital 282NC0060X 5042P ND 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
D01047MedicaidND

Other names 1

  • First Care Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000832 ND Part A Provider - Critical Access Hospital 0840102760 Receives reassigned benefits from 224 practitioners
Practice locations: Park River, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679669741. Details of each certification follow.

Hospital certification: CCN 351326

Legal name
P R HEALTH CORPORATION
Doing business as
FIRST CARE HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2002
Last certification
Nov 6, 2024
Beds
14
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 24, 1950 in ND
Enrollment address
First Care Health Center
115 Vivian St
Park River, ND 58270-4540
Main/Primary Hospital 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).

Care Compare: Hospital

Medicare Care Compare
Listed as
First Care Health CenterCCN 351326 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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 Jan 1, 2019
Lori Seim Individual W-2 Managing Employee Mar 1, 2013
Eugene Bossert Individual Corporate Director Jan 1, 2017
Gale Beneda Individual Corporate Director Jan 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 Jan 1, 2019
Marcus Lewis Individual Corporate OfficerCeo Dec 20, 2017
W-2 Managing EmployeeCeo Dec 20, 2017
Michael Helt Individual Corporate Director Jan 1, 2018
Patty Dahlen Individual Corporate Director Jan 1, 2018
Mark K Helgeson Individual Corporate Director Jan 1, 2015
Dennis Markusen Individual Corporate Director Jan 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 232

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 232

Affiliated clinicians 51

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

View all 51

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": "1679669741",
    "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "ND",
            "license": "5042P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D01047",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Care Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park River, ND

Sources for this page

Verify at the official NPI Registry.