NPIMap

Organization Active NPI

Mountrail County Medical Center, Inc.

  • Critical Access Hospital
  • Stanley, ND
National Provider Identifier
1740378637
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MOUNTRAIL COUNTY MEDICAL CENTER, INC.
Practice address
615 6TH St SE
Stanley, ND 58784-4444
Phone
(701) 628-2424
Fax
(701) 628-3990
NPI assigned
Oct 10, 2006
Last updated
Dec 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Ryan Gjellstad
Title
Board President
Phone
(701) 371-4930

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

615 6TH St SE
Stanley, ND 58784-4444

Mailing address

PO Box 399
Stanley, ND 58784-0399
Phone (701) 628-8602

Other identifiers 3

IdentifierTypeStateIssuer
00604OtherNDBLUE CROSS
1459885MedicaidND
01053MedicaidND

Other names 1

  • CAH Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000806 ND Part A Provider - Critical Access Hospital 9739088931 Receives reassigned benefits from 8 practitioners
Practice locations: Stanley, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740378637. Details of each certification follow.

Hospital certification: CCN 351301

Legal name
MOUNTRAIL COUNTY MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 1999
Last certification
Nov 22, 2023
Beds
11
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 6, 1997 in ND
Enrollment address
615 6TH St SE
Stanley, ND 58784-4444

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
Mountrail County Medical Center IncCCN 351301 · 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
Cah3 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.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Brittany Haugtvedt Individual W-2 Managing EmployeeDon Jan 17, 2022
Stephanie Everett Individual Corporate OfficerCeo/Administrator Jan 29, 2020
W-2 Managing EmployeeCeo/Administrator Sep 27, 2013
Ryan Gjellstad Individual Corporate OfficerPresident Dec 22, 2022
Corporate DirectorPresident Dec 22, 2022
Eugeniya Griffin Individual Corporate DirectorCfo Oct 14, 2023
W-2 Managing Employee May 19, 2023
Jacob Carpenter Individual Corporate OfficerSecretary/Treasurer Dec 4, 2025
Corporate DirectorSecretary/Treasurer Dec 4, 2025
Gregory Toepfer Individual Corporate DirectorBoard Member Feb 26, 2026
Elliot Leinen Individual Corporate DirectorBoard Member Jan 23, 2025
Jamie Eugene Germundson Individual Corporate DirectorBoard Member Nov 21, 2024
Michael Sorenson Individual Corporate Officer Jan 25, 2024
Corporate DirectorBoard of Directors Member Oct 5, 1972
Trinity Health Organization, Minot, ND Corporation 5% Or Greater Direct Ownership Interest Jun 1, 2002
Mountrail Bethel Home Inc Organization, Stanley, ND Corporation 5% Or Greater Direct Ownership Interest Jun 1, 2002 50%

Owners & managing parties with NPI records 6

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

Facilities with the same owner 12

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

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.

Affiliated clinicians 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1740378637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587840399",
            "telephone_number": "701-628-8602",
            "fax_number": "701-628-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 6TH ST SE",
            "city": "STANLEY",
            "state": "ND",
            "postal_code": "587844444",
            "telephone_number": "701-628-2424",
            "fax_number": "701-628-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTRAIL COUNTY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "GJELLSTAD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "701-371-4930"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00604",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459885",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01053",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stanley, ND

Sources for this page

Verify at the official NPI Registry.