NPIMap

Organization Active NPI

Cavalier County Memorial Hospital Association

Doing business as Langdon Prairie Health

  • Rural Health Clinic/Center
  • Langdon, ND
National Provider Identifier
1730126640
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
5029 Issued in ND
Legal business name
CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION
Doing business as
Langdon Prairie Health
Practice address
901 2ND St
Langdon, ND 58249-2407
Phone
(701) 256-6120
Fax
(701) 256-6156
NPI assigned
May 31, 2006
Last updated
Jun 30, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Mr. Todd Christensen
Title
Interim Ceo
Phone
(701) 256-6172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 5029 ND Primary

Addresses

Primary practice location

901 2ND St
Langdon, ND 58249-2407

Mailing address

909 2ND St
Langdon, ND 58249-2407
Phone (701) 256-6100

Other identifiers 1

IdentifierTypeStateIssuer
1452090MedicaidND

Other names 3

  • Langdon Prairie Health Doing business as
  • Cavalier County Memorial Hosptial - Langdon Clinic Other name
  • Langdon Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100824000882 ND Part A Provider - Rural Health Clinic 5092623520 Practice locations: Langdon, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730126640. Details of each certification follow.

Rural health clinic certification: CCN 353437

Legal name
CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION
Doing business as
LANGDON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 12, 2002
Last certification
Jan 28, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 11, 1968 in ND
Enrollment address
901 2ND St
Langdon, ND 58249-2407
Related CCNs
351323

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).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D1052498Cavalier County Memorial Hospital Clinic901 2ND St, Langdon, ND 58249Certificate of waiverMar 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Walhalla Clinic4 organizations share this tax ID, including this one
Part of
Walhalla Clinic

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Jerry Nowatzki Individual Corporate DirectorGoverning Board Member Dec 20, 2018
Runa C Anderson Individual Corporate DirectorGoverning Board Member Nov 18, 2020
Darla J Roder Individual Corporate OfficerCoo Jan 15, 2016
William Van Noy Individual Corporate OfficerCfo Nov 1, 2019
W-2 Managing EmployeeCfo Nov 1, 2019
Todd W Gette Individual Corporate DirectorGoverning Board Member Nov 18, 2020
Jamie Nienhuis Individual Corporate OfficerCno Nov 6, 2015
Sarah R Mikkelsen Individual W-2 Managing Employee Oct 12, 2020
Kathryn M Kopf Individual Corporate DirectorGoverning Board Member Nov 20, 2019
Shauna Schneider Individual Corporate DirectorGoverning Board Member Nov 19, 2014
Jay Dubois Individual Corporate DirectorGoverning Board Member Nov 16, 2016
Jeffery Stanley Individual Corporate OfficerCeo Dec 17, 2018
Dawn Roppel Individual Corporate DirectorGoverning Board Member Nov 19, 2014

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1730126640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 2ND ST",
            "city": "LANGDON",
            "state": "ND",
            "postal_code": "582492407",
            "telephone_number": "701-256-6100",
            "fax_number": "701-256-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 2ND ST",
            "city": "LANGDON",
            "state": "ND",
            "postal_code": "582492407",
            "telephone_number": "701-256-6120",
            "fax_number": "701-256-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAVALIER COUNTY MEMORIAL HOSPITAL ASSOC",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "701-256-6172",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ND",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452090",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Langdon Prairie Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cavalier County Memorial Hosptial - Langdon Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cavalier County Memorial Hosptial - Langdon Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Langdon Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Langdon, ND

Sources for this page

Verify at the official NPI Registry.