NPIMap

Organization Active NPI

Northern Itasca Hospital District

Doing business as Bigfork Valley Communities

  • Skilled Nursing Facility
  • Bigfork, MN
National Provider Identifier
1831133990
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
330370 Issued in MN
Legal business name
NORTHERN ITASCA HOSPITAL DISTRICT
Doing business as
Bigfork Valley Communities
Practice address
258 Pine Tree Drive
Bigfork, MN 56628
Phone
(218) 743-3177
Fax
(218) 743-3559
NPI assigned
Jun 16, 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
Mr. Harold Daniel Odegaard
Title
Ceo
Phone
(218) 743-3177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 330370 MN Primary

Addresses

Primary practice location

258 Pine Tree Drive
Bigfork, MN 56628

Mailing address

258 Pine Tree Drive
P.O. Box 258
Bigfork, MN 56628
Phone (218) 743-3177

Other identifiers 7

IdentifierTypeStateIssuer
300410OtherMNUCARE
98592OtherMNARAZ
5025357OtherMNMEDICA CHOICE
2257OtherMNHEALTH PARTNERS
1010473OtherMNPREFERRED ONE
361259OtherMNHOSPICE
1547ENOOtherMNBLUE CROSS

Other names 1

  • Bigfork Valley Communities Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030520000065 MN Part A Provider - Skilled Nursing Facility 3274442173 Practice locations: Bigfork, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831133990. Details of each certification follow.

Skilled nursing facility certification: CCN 245529

Legal name
NORTHERN ITASCA HOSPITAL DISTRICT
Doing business as
BIGFORK VALLEY COMMUNITIES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1988
Last certification
Oct 23, 2024
Beds
40
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
258 Pine Tree Dr
Bigfork, MN 56628
Nursing home name
BIGFORK VALLEY COMMUNITIES

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: Nursing home

Medicare Care Compare
Listed as
Bigfork Valley CommunitiesCCN 245529 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
May 1, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4020.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Northern Itasca Hospital District7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Gregory Anselmo Individual Managing Control - Governing BodyBoard of Director Jan 1, 2025
Organization, Minneapolis, MN Adp of the SNF Sep 10, 2025
Darla a Anderson Individual Corporate OfficerCfo Nov 2, 2020
Adp of the SNF Nov 5, 2020
Heidi Watson Individual Managing Control - Governing BodyBoard of Director Jan 3, 2011
Daniel Heinecke Individual Managing Control - Governing BodyBoard of Director Jan 1, 2025
Gregory Cook Individual Managing Control - Governing BodyBoard of Director Sep 2, 2014
Larry Salmela Individual Managing Control - Governing BodyBoard of Director Jan 3, 2017
Carol a Gilbertson Individual Managing Control - Governing BodyBoard of Director - Vice Chair Jan 1, 2023
Northern Itasca Hospital District Organization, Bigfork, MN Operational/Managerial Control Jan 1, 1975
Clinton Cook Individual Managing Control - Governing BodyBoard of Director - Chair Jan 1, 2021
Tom Lamont Individual Managing Control - Governing BodyBoard of Director Sep 3, 2019
Teresa Kittridge Individual Managing Control - Governing BodyBoard of Director May 5, 2025
Jeffrey P Scrivner Individual Operational/Managerial Control Aug 1, 2002
Adp of the SNF Aug 1, 2002
Nathan Jon Hough Individual Corporate OfficerChief Executive Officer Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Adp of the SNF May 7, 2024
Kurt F Fredrickson Individual Managing Control - Governing BodyBoard of Director - Treasurer Nov 28, 2023
Amanda Niemala Individual Corporate DirectorDirector of Revenue Cycle Jan 2, 2008
Paula McKellar Individual Operational/Managerial Control Aug 11, 2025
Adp of the SNF Aug 11, 2025
Sally Sedgwick Individual Managing Control - Governing BodyBoard of Director - Secretary Oct 3, 2023
Jessica Anderson Individual Operational/Managerial Control Dec 30, 2024
Adp of the SNF Dec 30, 2024
Dan Sursely Individual Managing Control - Governing BodyBoard of Director Jan 1, 2019
Gordon Rahier Individual Managing Control - Governing BodyBoard of Director Jan 1, 2021

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 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bigfork Valley HospitalBigfork, MN, CCN 241316 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
Bigfork Valley HospitalBigfork, MN, CCN 24Z316 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831133990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 PINE TREE DRIVE",
            "address_2": "P.O. BOX 258",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3177",
            "fax_number": "218-743-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 PINE TREE DRIVE",
            "city": "BIGFORK",
            "state": "MN",
            "postal_code": "56628",
            "telephone_number": "218-743-3177",
            "fax_number": "218-743-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ITASCA HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODEGAARD",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-743-3177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "330370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "300410",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "98592",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "5025357",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "2257",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1010473",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPICE",
            "identifier": "361259",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1547ENO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bigfork Valley Communities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bigfork, MN

Sources for this page

Verify at the official NPI Registry.