Active NPI
St. Luke'S Home
- Skilled Nursing Facility
- Dickinson, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ST. LUKE'S HOME
- Practice address
- 242 10TH St W
Dickinson, ND 58601-3997 - Phone
- (701) 483-5000
- Fax
- (701) 483-5007
- NPI assigned
- Mar 19, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy Leanne Kreidt, MBA, MSN, RN
- Title
- Ceo
- Phone
- (701) 483-5000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
242 10TH St W
Dickinson, ND 58601-3997
Mailing address
242 10TH St W
Dickinson, ND 58601-3997
Phone (701) 483-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100220000421 | ND | Part A Provider - Skilled Nursing Facility | 1951445584 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Dickinson, ND |
Skilled nursing facility certification: CCN 355063
- Legal name
- ST. LUKE'S HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1978
- Last certification
- Apr 10, 2025
- Beds
- 88
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 27, 1978 in ND
- Enrollment address
- 242 10TH St W
Dickinson, ND 58601-3926 - Nursing home name
- ST LUKES HOME
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Lukes Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 1, 1978
- Medicare certification status
- Active
- Certified beds
- 88
National Provider Directory
National Provider Directory- Tax ID family
- St Luke'S Home
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Dickinson, ND
- NPI 1023062155
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Amy Graves | Corporate Director | May 19, 2017 | |
| Operational/Managerial Control | May 19, 2017 | ||
| Crystal M Fox | Operational/Managerial Control | May 3, 2011 | |
| Adp of the SNF | May 3, 2011 | ||
| Tom Wyckoff | Corporate Director | May 18, 2018 | |
| Operational/Managerial Control | May 18, 2018 | ||
| Patricia W Anderson | Operational/Managerial Control | Sep 1, 2025 | |
| Adp of the SNF | Sep 1, 2025 | ||
| Mary Nordsven | Corporate Director | May 19, 2017 | |
| Operational/Managerial Control | May 19, 2017 | ||
| Russell Murphy | Corporate Director | Jan 23, 2023 | |
| Operational/Managerial Control | Jan 23, 2023 | ||
| Patrick Healy | Corporate Director | May 21, 2020 | |
| Operational/Managerial Control | May 21, 2020 | ||
| Stepheny Reger | Corporate Director | May 20, 2025 | |
| Operational/Managerial Control | May 20, 2025 | ||
| James Odermann | Corporate Director | May 18, 2018 | |
| Operational/Managerial Control | May 18, 2018 | ||
| Darla Baranko | Corporate Director | May 20, 2025 | |
| Operational/Managerial Control | May 20, 2025 | ||
| Maryanne Marsh | Corporate Director | May 19, 2017 | |
| Operational/Managerial Control | May 19, 2017 | ||
| Amy L Kreidt | Corporate Officer | Feb 1, 2015 | 100% |
| Operational/Managerial Control | Feb 1, 2015 | ||
| Adp of the SNF | Feb 1, 2015 | ||
| Kevin Kouash | Corporate Director | May 20, 2025 | |
| Operational/Managerial Control | May 20, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Dickinson, ND
- NPI 1013970532
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Dickinson, ND
- NPI 1649367343
Affiliated clinicians 4
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": "1552953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660089600000",
"number": "1912466947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 10TH ST W",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586013997",
"telephone_number": "701-483-5000",
"fax_number": "701-483-5007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 10TH ST W",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586013997",
"telephone_number": "701-483-5000",
"fax_number": "701-483-5007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. LUKE'S HOME",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-19",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A",
"authorized_official_last_name": "KREIDT",
"authorized_official_first_name": "AMY",
"authorized_official_middle_name": "LEANNE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "701-483-5000",
"authorized_official_credential": "MBA, MSN, RN"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.