Active NPI
Ruby Valley Hospital
- Rural Health Clinic/Center
- Sheridan, MT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- License
- 10088
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66962 | Other | MT | BCBS RVH SHERIDAN RHC-FQC |
| 0720473 | Medicaid | MT |
Other names 2
- Ruby Valley Medical Center
- Ruby Valley Rural Health Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- Incorporated
- Jan 1, 1956 in MT
- Enrollment address
- 321 Madison St
Sheridan, MT 59749-9636 - Related CCNs
- 271319
Related certifications (CCN) 1
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).
-
- Medicare Defined Swing Bed Hospital Unit
- Sheridan, MT
- NPI 1174668164
6406764018
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Medicare Defined Swing Bed Hospital Unit
- Sheridan, MT
- NPI 1174668164
O20031208000631
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 27D1006916 | Ruby Valley Rural Health Clinic | Certificate of waiver | Dec 3, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Louis J Bartoletti | Corporate Officer | Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Carol Braach | Corporate Officer | Jul 31, 2008 | |
| Courtney Wood | W-2 Managing Employee | Nov 1, 2022 | |
| Landon Dybdal | Contracted Managing Employee | Jun 1, 2019 | |
| Corporate Officer | Jun 1, 2019 | 100% | |
| Tony L Simonsen | Corporate Director | Apr 23, 2015 | |
| Ruby Valley Hospital | 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 | Corporate Director | Jan 1, 2023 | |
| Charles L Gilman | Corporate Director | Jan 1, 2021 | |
| Theodore Woirhaye | Corporate Officer | Jan 1, 2022 | |
| W-2 Managing Employee | 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.
-
- Critical Access Hospital
- Sheridan, MT
- NPI 1083710651
5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, Operational/Managerial Control
-
- Medicare Defined Swing Bed Hospital Unit
- Sheridan, MT
- NPI 1174668164
5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, Operational/Managerial Control
-
- Rural Health Clinic/Center
- Twin Bridges, MT
- NPI 1336284264
5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, Operational/Managerial Control
-
- Family Medicine Physician
- Soldotna, AK
- NPI 1790133239
Corporate Officer, Operational/Managerial Control
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ruby Valley Medical Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Twin Bridges Medical Clinic | 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.
-
- Medicare Defined Swing Bed Hospital Unit
- Sheridan, MT
- NPI 1174668164
5% Or Greater Direct Ownership Interest
-
- Rural Health Clinic/Center
- Twin Bridges, MT
- NPI 1336284264
5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, Operational/Managerial Control
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Medicare Defined Swing Bed Hospital Unit
- Sheridan, MT
- NPI 1174668164
Ruby Valley Hospital
-
- Rural Health Clinic/Center
- Twin Bridges, MT
- NPI 1336284264
Ruby Valley Hospital
Practitioners & affiliated clinicians
Practitioners 20
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Sheridan, MT
- NPI 1679990394
-
- Nurse Practitioner
- Bozeman, MT
- NPI 1679097638
-
- Family Nurse Practitioner
- Sheridan, MT
- NPI 1083007637
-
- Family Nurse Practitioner
- Butte, MT
- NPI 1013519008
-
- Family Nurse Practitioner
- Sheridan, MT
- NPI 1710276688
-
- Family Medicine Physician
- Sheridan, MT
- NPI 1154908051
-
- Chiropractor
- Whitehall, MT
- NPI 1538347208
-
- Family Medicine Physician
- Soldotna, AK
- NPI 1790133239
-
- Family Medicine Physician
- Salem, OR
- NPI 1164786208
-
- Psychiatric/Mental Health Nurse Practitioner
- Old Town, ME
- NPI 1558497180
-
- Family Nurse Practitioner
- Twin Bridges, MT
- NPI 1689097156
-
- Diagnostic Radiology Physician
- Pocatello, ID
- NPI 1386610442
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.