NPIMap

Organization Active NPI

Cook Area Health Services, Inc

Doing business as Scenic Rivers Health Services

  • Clinic/Center
  • Northome, MN
National Provider Identifier
1912970849
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COOK AREA HEALTH SERVICES, INC
Doing business as
Scenic Rivers Health Services
Practice address
12052 Main St
Northome, MN 56661-0066
Phone
(218) 897-5222
Fax
(218) 897-5226
NPI assigned
Feb 10, 2006
Last updated
Aug 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Mr. Keith D Harvey
Title
Ceo
Phone
(218) 666-5941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

12052 Main St
Northome, MN 56661-0066

Mailing address

PO Box 66
12052 Main St
Northome, MN 56661-0066
Phone (218) 897-5222

Other names 1

  • Scenic Rivers Health Services Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040427001470 MN Part B Supplier - Clinic/Group Practice 4880681303 Receives reassigned benefits from 35 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eveleth, MN; Tower, MN; Northome, MN; Floodwood, MN; Cook, MN; Bigfork, MN; Big Falls, MN
O20040707000142 MN Part A Provider - Federally Qualified Health Center (FQHC) 4880681303 Practice locations: Northome, MN
O20101119001059 MN Part A Provider - Federally Qualified Health Center (FQHC) 4880681303 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Big Falls, MN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1912970849. Details of each certification follow.

Federally qualified health center certification: CCN 241812

Legal name
COOK AREA HEALTH SERVICES, INC
Doing business as
SCENIC RIVERS HEALTH SERVICES
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1979 in MN
Enrollment address
12052 Main St
Northome, MN 56661-8074

Federally qualified health center certification: CCN 241811

Legal name
COOK AREA HEALTH SERVICES, INC
Doing business as
SCENIC RIVERS HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1979 in MN
Enrollment address
410 2ND St NW
Big Falls, MN 56627-0218

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Stephanie a Burckhardt Individual Corporate DirectorBoard Member Jan 1, 2015
Wende Nelson Individual Corporate DirectorBoard Member Jan 1, 2016
Daniel Kerr Individual Corporate DirectorBoard Member Jan 1, 2019
Robert Walker Individual Corporate DirectorBoard Member Jan 1, 2019
Corporate Director Jan 1, 2021
Mary G Blackmer Individual Corporate OfficerSecretary/Treasurer Jan 1, 1992
Corporate DirectorSecretary/Treasurer Jan 1, 1992
Karen M Lorenzen Individual Corporate DirectorBoard Member Jan 1, 2013
William N Swanberg Individual Corporate DirectorBoard Member Jul 1, 2018
Richard V Hanson Individual Corporate DirectorBoard Member Apr 1, 2017
Corporate Director Apr 1, 2017
W-2 Managing EmployeeCeo May 1, 1979
Marian a Swang Individual Corporate DirectorBoard Member Jan 1, 2013
Michael a Holmes Individual Corporate Officer May 1, 1979
W-2 Managing EmployeeCeo May 1, 1979
Operational/Managerial ControlCeo May 1, 1979
Corporate OfficerChief Executive Officer Jun 23, 2010
Jeffrey P Scrivner Individual W-2 Managing EmployeeMedical Director Nov 1, 1987
Operational/Managerial ControlMedical Director Nov 1, 1984
Diane J Gallagher Individual Corporate Director Apr 1, 2017
William H Tibbetts Individual Corporate OfficerPresident Jan 1, 2002
Corporate DirectorPresident Jan 1, 2002
Keith D Harvey Individual Corporate OfficerCfo Jul 21, 2014
W-2 Managing EmployeeCfo Jul 21, 2014
Operational/Managerial ControlCfo Jul 21, 2014
Corporate OfficerChief Financial Officer Jul 21, 2014
Dianne L Bakke Individual Corporate DirectorBoard Member Jan 1, 2015
Elizabeth G Storm Individual Corporate DirectorBoard Member Jan 1, 2022
Marci L Maple Individual Corporate DirectorBoard Member Jan 1, 2021
Robin Harkonen Individual Corporate DirectorBoard Member Jan 1, 2021

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 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1912970849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "address_2": "12052 MAIN ST",
            "city": "NORTHOME",
            "state": "MN",
            "postal_code": "566610066",
            "telephone_number": "218-897-5222",
            "fax_number": "218-897-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12052 MAIN ST",
            "city": "NORTHOME",
            "state": "MN",
            "postal_code": "566610066",
            "telephone_number": "218-897-5222",
            "fax_number": "218-897-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK AREA HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-666-5941",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scenic Rivers Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northome, MN

Sources for this page

Verify at the official NPI Registry.