NPIMap

Organization Active NPI

Mountrail County Medical Center, Inc.

  • Rural Health Clinic/Center
  • Stanley, ND
National Provider Identifier
1831289362
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MOUNTRAIL COUNTY MEDICAL CENTER, INC.
Practice address
615 6TH St SE
Stanley, ND 58784-4444
Phone
(701) 628-2505
Fax
(701) 628-3990
NPI assigned
Oct 13, 2006
Last updated
Nov 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Stephanie Everett
Title
Ceo
Phone
(701) 628-8603

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X 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 2

IdentifierTypeStateIssuer
12830MedicaidND
05057MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040107000468 ND Part B Supplier - Clinic/Group Practice 9739088931 Receives reassigned benefits from 13 practitioners
Practice locations: Stanley, ND
O20101202000101 ND Part A Provider - Rural Health Clinic 9739088931 Practice locations: Stanley, ND
O20250520001668 WI Part B Supplier - Clinic/Group Practice 9739088931 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831289362. Details of each certification follow.

Rural health clinic certification: CCN 353407

Legal name
MOUNTRAIL COUNTY MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 24, 1993
Last certification
Jan 17, 2023
Ownership / control type
2B
Most recent change of ownership
Oct 31, 1997 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 6, 1997 in ND
Enrollment address
615 6TH St SE
Stanley, ND 58784-4444
Related CCNs
351301

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).

National Provider Directory

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
Stephanie Everett Individual Corporate OfficerCeo Jan 29, 2020
W-2 Managing Employee Sep 27, 2013
Operational/Managerial Control Jan 1, 2019
Ryan Gjellstad Individual Corporate OfficerPresident Dec 22, 2022
Corporate DirectorPresident Dec 22, 2022
Eugeniya Griffin Individual Corporate OfficerCfo 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 Director Jan 23, 2025
Jamie Eugene Germundson Individual Corporate DirectorBoard Member Nov 21, 2024
Janel Borud Individual W-2 Managing Employee Aug 21, 1997
Operational/Managerial Control Jun 1, 2019
Michael Sorenson Individual Corporate Officer Jan 25, 2024
Corporate DirectorBoard of Directors Member Nov 1, 2014 17%
Trinity Health Organization, Minot, ND Non-profit 5% Or Greater Direct Ownership Interest Oct 31, 1997 50%
Operational/Managerial Control Oct 31, 1997 50%
Mountrail Bethel Home Inc Organization, Stanley, ND Non-profit 5% Or Greater Direct Ownership Interest Oct 31, 1997 50%
Operational/Managerial Control Oct 31, 1997 50%

Owners & managing parties with NPI records 5

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

  • Mountrail Bethel Home, Inc.
    • Skilled Nursing Facility
    • Stanley, ND
    • NPI 1184712002

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Trinity Health

    dba Trinity Medical Group

    • Multi-Specialty Clinic/Center
    • Minot, ND
    • NPI 1083653752

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Trinity Health

    dba TCC-Western Dakota Lab

    • Clinical Medical Laboratory
    • Williston, ND
    • NPI 1316273998

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Trinity Health

    dba Western Dakota Surgery

    • Ambulatory Surgical Clinic/Center
    • Williston, ND
    • NPI 1538214689

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Trinity Health

    dba Vision Galleria

    • Eyewear Supplier
    • Minot, ND
    • NPI 1982770996

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1831289362",
    "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": "701-628-2505",
            "fax_number": "701-628-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTRAIL COUNTY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-628-8603"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12830",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05057",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanley, ND

Sources for this page

Verify at the official NPI Registry.