NPIMap

Organization Active NPI

Missoula Community Health Services, Inc.

Doing business as Mineral Community Hospital

  • Critical Access Hospital
  • Superior, MT
National Provider Identifier
1902990005
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
10034 Issued in MT
Legal business name
MISSOULA COMMUNITY HEALTH SERVICES, INC.
Doing business as
Mineral Community Hospital
Practice address
1208 6TH Ave E
Superior, MT 59872-9618
Phone
(406) 822-4841
Fax
(406) 822-4963
NPI assigned
Oct 3, 2006
Last updated
Apr 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Mr. John S McNeece
Title
Ceo
Phone
(406) 822-4841

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 10034 MT Primary
Rural Acute Care Hospital 282NR1301X 10034 MT

Addresses

Primary practice location

1208 6TH Ave E
Superior, MT 59872-9618

Mailing address

PO Box 66
Superior, MT 59872-0066
Phone (406) 822-4841

Other names 1

  • Mineral Community Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061104000554 MT Part A Provider - Critical Access Hospital 6709790603 Receives reassigned benefits from 17 practitioners
Practice locations: Superior, MT
O20190313001297 MT Part B Supplier - Hospital Department(S) 6709790603 Receives reassigned benefits from 20 practitioners
Practice locations: Superior, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902990005. Details of each certification follow.

Hospital certification: CCN 271331

Legal name
MISSOULA COMMUNITY HEALTH SERVICES, INC
Doing business as
MINERAL COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2002
Last certification
May 28, 2024
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Jun 27, 1984 in MT
Enrollment address
1208 6TH Ave
Superior, MT 59872-9667
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Mineral Community HospitalCCN 271331 · 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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Kristy Mask Individual W-2 Managing EmployeeBusiness Office Supervisor Jan 21, 2019
Carol Billadeau Individual Corporate Director Sep 1, 2012
Leona Belle Crichton Individual Corporate Director Sep 1, 2014
Laurel G Chambers Haskins Individual Corporate OfficerCeo Jan 1, 2020
Corporate DirectorCeo Jan 1, 2020
W-2 Managing EmployeeCeo Jan 1, 2020
Stacy Conrow-Ververis Individual Corporate OfficerCfo Jan 1, 2020
Corporate DirectorCfo Jan 1, 2020
W-2 Managing Employee Jun 10, 2002
Operational/Managerial ControlCfo Jan 1, 2020
John Woodland Individual Corporate Director May 1, 2013

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 27

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 27

Affiliated clinicians 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1902990005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598720066",
            "telephone_number": "406-822-4841",
            "fax_number": "406-822-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 6TH AVE E",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729618",
            "telephone_number": "406-822-4841",
            "fax_number": "406-822-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "MCNEECE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-822-4841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MT",
            "license": "10034",
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MT",
            "license": "10034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mineral Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mineral Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Superior, MT

Sources for this page

Verify at the official NPI Registry.