Organization Active NPI

Dunseith Community Nursing Home

  • Skilled Nursing Facility
  • Dunseith, ND
National Provider Identifier
1811039316
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1016A Issued in ND
Legal business name
DUNSEITH COMMUNITY NURSING HOME
Practice address
15 First St NE
Dunseith, ND 58329
Phone
(701) 244-5495
Fax
(701) 244-5431
NPI assigned
Feb 12, 2007
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Mr. Justin Lee Decoteau
Title
Administrator
Phone
(701) 244-5495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1016A ND Primary

Addresses

Primary practice location

15 First St NE
Dunseith, ND 58329

Mailing address

Box 669 15 First St NE
Dunseith, ND 58329
Phone (701) 244-5495

Other identifiers 1

IdentifierTypeStateIssuer
30052MedicaidND

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051010000379 ND Part A Provider - Skilled Nursing Facility 3971528993 Practice locations: Dunseith, ND
O20091222000186 ND Part B Supplier - Mass Immunization (Roster Biller Only) 3971528993 Practice locations: Dunseith, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811039316. Details of each certification follow.

Skilled nursing facility certification: CCN 355080

Legal name
DUNSEITH COMMUNITY NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1978
Last certification
May 2, 2024
Beds
30
Ownership / control type
City
Organization structure
OtherNon-profit
Enrollment address
15 1St St NE
Dunseith, ND 58329-0669
Nursing home name
DUNSEITH COM NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Dunseith Com Nursing HomeCCN 355080 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - City
Certified
Nov 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3020.5 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $92,954

Processed by Care Compare on Aug 1, 2026.

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
35D0408661Dunseith Community Nursing Home15 1St St NE, Dunseith, ND 58329Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Alva Gladue Individual Managing Control - Governing BodyBoard of Directors - Members Nov 29, 2023
City of Dunseith Organization, Dunseith, ND Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 6, 1974 100%
5% Or Greater Security Interest May 6, 1974 100%
George Gottbreht Individual Managing Control - Governing BodyBoard of Directors - Members Jul 1, 2002
Justin Lee Decoteau Individual Operational/Managerial Control Aug 21, 2021
Adp of the SNF Aug 21, 2021
Brian L Selland Individual Operational/Managerial Control Jan 20, 2014
Adp of the SNF May 20, 2025
Linda Gunville Individual Managing Control - Governing BodyBoard of Directors - Members Sep 19, 2019
Janice Azure Individual Managing Control - Governing BodyBoard of Directors - Members Dec 8, 2022
Chris Strong Individual Managing Control - Governing BodyBoard of Directors - Members Jul 6, 2022

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1811039316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 669 15 FIRST ST NE",
            "city": "DUNSEITH",
            "state": "ND",
            "postal_code": "58329",
            "telephone_number": "701-244-5495",
            "fax_number": "701-244-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FIRST ST NE",
            "city": "DUNSEITH",
            "state": "ND",
            "postal_code": "58329",
            "telephone_number": "701-244-5495",
            "fax_number": "701-244-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNSEITH COMMUNITY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "DECOTEAU",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-244-5495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1016A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30052",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunseith, ND

Sources for this page

Verify at the official NPI Registry.