NPIMap

Organization Active NPI

St. Andrew's Hospital

Doing business as SMP Health - St. Andrew's

  • Critical Access Hospital
  • Bottineau, ND
National Provider Identifier
1801893706
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
ST. ANDREW'S HOSPITAL
Doing business as
SMP Health - St. Andrew's
Practice address
316 Ohmer St
Bottineau, ND 58318-1045
Phone
(701) 228-9300
Fax
(701) 228-9384
NPI assigned
Jul 7, 2005
Last updated
Dec 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Ms. Brenda Arneson
Title
Human Resource Director
Phone
(701) 228-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

316 Ohmer St
Bottineau, ND 58318-1045

Mailing address

316 Ohmer St
Bottineau, ND 58318-1045
Phone (701) 228-9300

Other identifiers 1

IdentifierTypeStateIssuer
01004MedicaidND

Other names 1

  • SMP Health - St. Andrew's Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110328000552 ND Part A Provider - Critical Access Hospital 4880505999 Receives reassigned benefits from 31 practitioners
Practice locations: Bottineau, ND
O20210202002562 ND Part A Provider - Rural Health Clinic 4880505999 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bottineau, ND

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1801893706. Details of each certification follow.

Hospital certification: CCN 351307

Legal name
ST ANDREWS HOSPITAL
Doing business as
SMP HEALTH - ST ANDREW'S
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2000
Last certification
Mar 11, 2026
Beds
25
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1945 in ND
Enrollment address
316 Ohmer St
Bottineau, ND 58318-1045

Rural health clinic certification: CCN 358508

Legal name
ST ANDREWS HOSPITAL
Doing business as
SMP HEALTH - ST. ANDREW'S
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 19, 2017
Last certification
Feb 13, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1945 in ND
Enrollment address
314 Ohmer St
Bottineau, ND 58318-1059
Related CCNs
351307

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
St Andrew's HospitalCCN 351307 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

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
Brenda Arneson Individual W-2 Managing Employee Jan 1, 2019
Melissa Block Individual Corporate Director Jul 1, 2015 100%
Corporate DirectorBoard Member Jul 1, 2015 100%
Collin Serhienko Individual Corporate DirectorDirector Jul 1, 2023 100%
Rick Gustafson Individual Corporate Director Jul 1, 2021 100%
Jeremi Tweed Individual Corporate Director Jul 1, 2017 100%
Christopher Albertson Individual Corporate OfficerCeo/President Oct 1, 2020 100%
Operational/Managerial ControlCeo/President Oct 1, 2020 100%
Courtney Vandal Individual Corporate OfficerCfo Aug 1, 2020
Darin Bohl Individual Corporate DirectorBoard Member Jul 1, 2017 100%
Daniel Bullinger Individual Corporate DirectorBoard Member Jan 1, 2017 100%
St Andrews Hospital Organization, Bottineau, ND Non-profit 5% Or Greater Direct Ownership Interest Nov 30, 2020 100%
Dorothy C Bunce Individual Corporate DirectorBoard Member Jul 1, 2009 100%

Owners & managing parties with NPI records 3

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
SMP Health - St. Andrew'sBottineau, ND, CCN 358508 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 30, 2020

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 33

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 33

Affiliated clinicians 80

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

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1801893706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 OHMER ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181045",
            "telephone_number": "701-228-9300",
            "fax_number": "701-228-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 OHMER ST",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181045",
            "telephone_number": "701-228-9300",
            "fax_number": "701-228-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANDREW'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "ARNESON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "HUMAN RESOURCE DIRECTOR",
        "authorized_official_telephone_number": "701-228-9300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMP Health - St. Andrew's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bottineau, ND

Sources for this page

Verify at the official NPI Registry.