Organization Active NPI

Ruby Valley Hospital

  • Rural Health Clinic/Center
  • Sheridan, MT
National Provider Identifier
1962547653
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
10088 Issued in MT
Legal business name
RUBY VALLEY HOSPITAL
Practice address
321 Madison Street
Sheridan, MT 59749-0366
Phone
(406) 842-5056
Fax
(406) 842-5057
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Jim Gillhouse
Title
Ceo
Phone
(406) 842-5453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 10088 MT Primary

Addresses

Primary practice location

321 Madison Street
Sheridan, MT 59749-0366

Mailing address

PO Box 336
Sheridan, MT 59749-0336
Phone (406) 842-5453

Other identifiers 2

IdentifierTypeStateIssuer
66962OtherMTBCBS RVH SHERIDAN RHC-FQC
0720473MedicaidMT

Other names 2

  • Ruby Valley Medical Center Doing business as
  • Ruby Valley Rural Health Clinic Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021016000015 MT Part A Provider - Rural Health Clinic 6406764018 Practice locations: Sheridan, MT
O20031208000631 MT Part B Supplier - Clinic/Group Practice 6406764018 Receives reassigned benefits from 41 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sheridan, MT

Rural health clinic certification: CCN 273405

Legal name
RUBY VALLEY HOSPITAL
Doing business as
RUBY VALLEY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 4, 2003
Last certification
Jan 22, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1956 in MT
Enrollment address
321 Madison St
Sheridan, MT 59749-9636
Related CCNs
271319

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).

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D1006916Ruby Valley Rural Health Clinic321 Madison St, Sheridan, MT 59749Certificate of waiverDec 3, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Louis J Bartoletti Individual Corporate OfficerChief Medical Officer Jan 1, 2024
Operational/Managerial ControlChief Medical Officer Jan 1, 2024
Carol Braach Individual Corporate OfficerSecretary - Board Jul 31, 2008
Courtney Wood Individual W-2 Managing EmployeeBusiness Office Manager Nov 1, 2022
Landon Dybdal Individual Contracted Managing Employee Jun 1, 2019
Corporate OfficerChief Executive Officer Jun 1, 2019 100%
Tony L Simonsen Individual Corporate DirectorDirector Apr 23, 2015
Ruby Valley Hospital Organization, Sheridan, MT 5% Or Greater Direct Ownership Interest Jan 1, 1987 100%
5% Or Greater Mortgage Interest Jan 1, 1987 100%
Operational/Managerial Control Jan 1, 1987 100%
Cleve P Witham Individual Corporate DirectorBoard - Vice President Jan 1, 2023
Charles L Gilman Individual Corporate DirectorBoard - President Jan 1, 2021
Theodore Woirhaye Individual Corporate OfficerChief Nursing Officer Jan 1, 2022
W-2 Managing EmployeeChief Nursing Officer Jan 1, 2022

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ruby Valley Medical CenterSheridan, MT, CCN 27Z319 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Twin Bridges Medical ClinicTwin Bridges, MT, CCN 273409 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (100%)
Operational/Managerial Control (100%)
Jan 1, 2003
Jan 1, 2003
Jan 1, 2003

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1962547653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336",
            "city": "SHERIDAN",
            "state": "MT",
            "postal_code": "597490336",
            "telephone_number": "406-842-5453",
            "fax_number": "406-842-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MADISON STREET",
            "city": "SHERIDAN",
            "state": "MT",
            "postal_code": "597490366",
            "telephone_number": "406-842-5056",
            "fax_number": "406-842-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY VALLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "GILLHOUSE",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-842-5453"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MT",
            "license": "10088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RVH SHERIDAN RHC-FQC",
            "identifier": "66962",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720473",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ruby Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ruby Valley Rural Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sheridan, MT

Sources for this page

Verify at the official NPI Registry.