NPIMap

Organization Active NPI

Northern Itasca Hospital District

Doing business as Bigfork Valley Hospital

  • Critical Access Hospital
  • Bigfork, MN
National Provider Identifier
1851335525
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
331040 Issued in MN
Legal business name
NORTHERN ITASCA HOSPITAL DISTRICT
Doing business as
Bigfork Valley Hospital
Practice address
258 Pine Tree Drive
Bigfork, MN 56628
Phone
(218) 743-3177
Fax
(218) 743-3559
NPI assigned
Jun 15, 2006
Last updated
Aug 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Aaron Christopher Saude
Title
Ceo
Phone
(218) 743-4115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 331040 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 9

IdentifierTypeStateIssuer
1010473OtherMNPREFERRED ONE
361259OtherMNHOSPICE
2257OtherMNHEALTH PARTNERS
5025357OtherMNMEDICA CHOICE
048545400MedicaidMN
1547HNOOtherMNBLUE CROSS
98592OtherMNARAZ
048545400OtherMNIMCARE
300410OtherMNUCARE

Other names 1

  • Bigfork Valley Hospital Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address his@direct.bigforkvalley.org Direct
RESTful URL mtrestapps-live01.bigforkvalley.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20060505000928 MN Part A Provider - Critical Access Hospital 3274442173 Receives reassigned benefits from 11 practitioners
Practice locations: Bigfork, MN
O20060911000628 MN Part B Supplier - Clinic/Group Practice 3274442173 Receives reassigned benefits from 22 practitioners
Practice locations: Bigfork, MN
O20260304002490 MN Part B Supplier - Ambulance Service Supplier 3274442173 Practice locations: Bigfork, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851335525. Details of each certification follow.

Hospital certification: CCN 241316

Legal name
NORTHERN ITASCA HOSPITAL DISTRICT
Doing business as
BIGFORK VALLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2001
Last certification
May 10, 2018
Beds
20
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
258 Pine Tree Drive
Bigfork, MN 56628
Other Hospital Practice Location

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
Bigfork Valley HospitalCCN 241316 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

41150 Scenic Hwy
Bovey, MN 55709

41150 Scenic Hwy
Ste 7
Bovey, MN 55709

Interoperability endpoints

  • Direct secure messaging: his@direct.bigforkvalley.org

Ownership & related parties

All disclosed owners & managing parties 17

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 Corporate DirectorBoard of Director Jan 1, 2025
Darla a Anderson Individual Corporate OfficerCfo Nov 2, 2020
W-2 Managing EmployeeCfo Nov 2, 2020
Heidi Watson Individual Corporate DirectorBoard of Director Jan 1, 2015
Daniel Heinecke Individual Corporate DirectorBoard of Director Jan 1, 2025
Gregory Cook Individual Corporate DirectorBoard of Director Sep 2, 2014
Larry Salmela Individual Corporate DirectorBoard of Director Jan 3, 2017
Carol a Gilbertson Individual Corporate DirectorBoard of Director Jan 1, 2023
Northern Itasca Hospital District Organization, Bigfork, MN 5% Or Greater Direct Ownership Interest Jan 1, 1975 100%
Clinton Cook Individual Corporate DirectorBoard of Director Jan 1, 2021
Tom Lamont Individual Corporate DirectorBoard of Director Sep 3, 2019
Teresa Kittridge Individual Corporate DirectorBoard of Director Apr 7, 2020
Nathan Jon Hough Individual Corporate OfficerChief Executive Officer Apr 1, 2024
W-2 Managing EmployeeChief Executive Officer Apr 1, 2024
Kurt F Fredrickson Individual Corporate DirectorBoard of Director Nov 28, 2023
Amanda Niemala Individual W-2 Managing EmployeeDirector of Revenue Cycle Jan 2, 2008
Sally Sedgwick Individual Corporate DirectorBoard of Director Oct 3, 2023
Dan Sursely Individual Corporate DirectorBoard of Director Jan 1, 2019
Gordon Rahier Individual Corporate DirectorBoard of Director Jan 1, 2021

Owners & managing parties with NPI records 2

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 24Z316 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
Bigfork Valley CommunitiesBigfork, MN, CCN 245529 Skilled nursing facility Operational/Managerial Control 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 26

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 26

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": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1851335525",
    "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": "2006-06-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "SAUDE",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-743-4115"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MN",
            "license": "331040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "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": "HEALTH PARTNERS",
            "identifier": "2257",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "5025357",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048545400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1547HNO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "98592",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMCARE",
            "identifier": "048545400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "300410",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "his@direct.bigforkvalley.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "258 Pine Tree Drive",
            "city": "Bigfork",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "mtrestapps-live01.bigforkvalley.org",
            "affiliation": "N",
            "address_1": "258 Pine Tree Drive",
            "city": "Bigfork",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bigfork Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bigfork Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bigfork, MN

Sources for this page

Verify at the official NPI Registry.