NPIMap

Organization Active NPI

First Care Medical Services

  • Medicare Defined Swing Bed Hospital Unit
  • Fosston, MN
National Provider Identifier
1942409545
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
FIRST CARE MEDICAL SERVICES
Practice address
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone
(218) 435-1133
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Kim Bodensteiner
Title
Cfo
Phone
(218) 435-7633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

900 Hilligoss Blvd SE
Fosston, MN 56542-1542

Mailing address

900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone (218) 435-1133

Other identifiers 1

IdentifierTypeStateIssuer
1643EFOOtherMNBLUE CROSS SWINGBED

Other names 1

  • Essentia Health Fosston Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000708 MN Part A Provider - Critical Access Hospital 3678542842 Practice locations: Fosston, MN

Hospital certification: CCN 24Z357

Legal name
FIRST CARE MEDICAL SERVICES
Doing business as
ESSENTIA HEALTH FOSSTON
Organization structure
CorporationNon-profit
Incorporated
May 26, 1947 in MN
Enrollment address
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
First Care Medical Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

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.

NameRoleSinceShare
Stefanie Gefroh Ellison Individual Corporate OfficerPresident Aug 12, 2024
Tim D Heilman Individual Corporate DirectorBoard Member Jan 1, 2020
Aarick L Jackson Individual Corporate DirectorBoard Member Jan 1, 2020
Mark Gordon Finstad Individual Corporate DirectorBoard Member Feb 15, 2022
James M Christensen Individual Corporate DirectorBoard Member Jan 1, 2020
Taylor Grant Mertz Individual Corporate DirectorBoard Member May 17, 2022
Michael Watters Individual Corporate OfficerSecretary Jul 1, 2023
Alan J Hurley Individual Corporate OfficerCoo May 18, 2023
W-2 Managing Employee May 18, 2023
Benjamin Cody Smith Individual Corporate DirectorBoard Member May 17, 2022
Douglas J Arvin Individual Corporate OfficerVP of Finance / Cfo May 18, 2023
W-2 Managing EmployeeVP of Finance / Cfo May 18, 2023
Joel Ross Haugen Individual Corporate DirectorBoard Member Jan 1, 2017
Laurie Ann Lewandowski Individual Corporate DirectorBoard Member Jan 1, 2017
Innovis Health LLC Organization, Fargo, ND LLC, Non-profit Operational/Managerial Control Jan 1, 2017

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 23

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1942409545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HILLIGOSS BLVD SE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421542",
            "telephone_number": "218-435-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HILLIGOSS BLVD SE",
            "city": "FOSSTON",
            "state": "MN",
            "postal_code": "565421542",
            "telephone_number": "218-435-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "BODENSTEINER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-435-7633"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SWINGBED",
            "identifier": "1643EFO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Essentia Health Fosston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Essentia Health Fosston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fosston, MN

Sources for this page

Verify at the official NPI Registry.