Four Seasons Healthcare Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1075B Issued in ND

Legal business name

FOUR SEASONS HEALTHCARE CENTER INC

Practice address

483 4TH St SW
Forman, ND 58032-4210

Phone

(701) 724-6211

Fax

(701) 724-3060

NPI assigned

Jan 4, 2006

Last updated

Oct 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dede Cookson

Title

Administrator

Phone

(701) 724-6211

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861470429. Details of each certification follow.

• CCN 355103 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 355103

Legal name

FOUR SEASONS HEALTHCARE CENTER INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 1, 1991

Last certification

Oct 30, 2024

Beds

25

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Mar 1, 2001 in ND

Enrollment address

483 4TH St SW
Forman, ND 58032-4210

Nursing home name

FOUR SEASONS HEALTH CARE INC

Listed as

Four Seasons Health Care IncCCN 355103 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

May 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2523.3 residents per day on average

Penalties (3 years)

3Fines totaling $115,484

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 9

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

Practitioners 4

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.

• Nathan Wilbur Schlecht, R.PH.

  • Pharmacist
  • Forman, ND
  • NPI 1427046093
  NPD
• Andrew Herting, MD

  • Internal Medicine Physician
  • Valley City, ND
  • NPI 1841867074
  NPD (past)
• Hima Bindu Kondragunta

  • Internal Medicine Physician
  • Lisbon, ND
  • NPI 1760985584
  NPD (past)
• Tara Renae Mertz-Hack, MD

  • Family Medicine Physician
  • Oakes, ND
  • NPI 1245641489
  NPD (past)

Affiliated clinicians 1

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

• Andrew Herting, MD

  • Internal Medicine Physician
  • Valley City, ND
  • NPI 1841867074

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1861470429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 4TH ST SW",
            "city": "FORMAN",
            "state": "ND",
            "postal_code": "580324210",
            "telephone_number": "701-724-6211",
            "fax_number": "701-724-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 4TH ST SW",
            "city": "FORMAN",
            "state": "ND",
            "postal_code": "580324210",
            "telephone_number": "701-724-6211",
            "fax_number": "701-724-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS HEALTHCARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "COOKSON",
        "authorized_official_first_name": "DEDE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-724-6211",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ND",
            "license": "8070A",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1075B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BASIC CARE",
            "identifier": "30762",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30406",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Sargent (Sargent County District Health Unit)
• Forman Drug Inc
• Michele H Gilbertson
• Kari Gilje, LSW
• Rosanne Clare Lohman, NP-C
• Kelsy Martinson, PHARMD
• Sanford Medical Center Fargo (Sanford Health Forman Clinic)

• Skilled Nursing Facility in Forman, ND
• Providers in Forman, ND by specialty
• Skilled Nursing Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.