JACOBSON MEMORIAL HOSPITAL CARE CENTER (NPI# 1184002347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184002347 |
| Entity Type | Organization |
| Organization Name | JACOBSON MEMORIAL HOSPITAL CARE CENTER |
| Practice Address |
601 East St N Elgin ND 58533-7105 |
| Mailing Address |
601 East St N Po Box 367 Elgin ND 58533-7105 |
| Practice Telephone | 7015842792 |
| Practice Fax Number | 7015843348 |
| Mailing Telephone | 7015842792 |
| Mailing Fax Number | 7015843348 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-11 |
| Authorized Official Name | THEO A STOLLER (CEO) |
| Authorized Official Telephone | 7015847247 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 5014 | ND | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | MEDICARE PTAN | 35Z314 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043649486 | Jacobson Memorial Hospital Care Center | Clinic/Center | 215 3rd Ave W, Richardton, ND 58652-7109 | 2013-11-06 |
| 1629165915 | Jacobson Memorial Hospital Care Center | Skilled Nursing Facility | 601 E Street N, Elgin, ND 58533 | 2006-10-06 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| 1376651463 | Jacobson Memorial Hospital Care Center | Clinic/Center | 811 Main St, Hebron, ND 58638 | 2006-08-28 |
| 1003929944 | Jacobson Memorial Hospital Care Center | Clinic/Center | 602 Ash Ave E, Glen Ullin, ND 58631 | 2006-08-16 |
| 1336196039 | Jacobson Memorial Hospital Care Center | General Acute Care Hospital | 601 East St N, Elgin, ND 58533-7105 | 2006-05-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JACOBSON MEMORIAL HOSPITAL CARE CENTER | 601 East St N, Elgin, ND 58533-7105 |
| Street Address |
601 EAST ST N |
| City | ELGIN |
| State | ND |
| Zip Code | 58533-7105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336196039 | Jacobson Memorial Hospital Care Center | General Acute Care Hospital | 601 East St N, Elgin, ND 58533-7105 | 2006-05-28 |
| 1154952083 | April Berger | Nurse Practitioner | 601 East St N, Elgin, ND 58533-7105 | 2020-01-29 |
| 1013375500 | Arthur Renner | Physician Assistant | 601 East St N, Elgin, ND 58533-7105 | 2016-01-29 |
| 1811398365 | Joseph Dragon | Nurse Practitioner | 601 East St N, Elgin, ND 58533-7105 | 2014-09-15 |
| 1225294101 | Carey Elizabeth Rivinius | Nurse Practitioner | 601 East St N, Elgin, ND 58533-7105 | 2008-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740820299 | Three In One Physical Therapy, Pllc | Physical Therapist | 207 Main Street North, Elgin, ND 58533 | 2020-01-13 |
| 1033233150 | Nancy L Mcpherson | Physician Assistant | 603 East St North, Jacobson Memorial Hospital Care Center, Elgin, ND 58533 | 2007-03-16 |
| 1811036247 | Tyesha Dawn Marie Dent | Physician Assistant | 302 North Main, Elgin, ND 58533 | 2007-02-05 |
| 1407902919 | Elizabeth Elaine Sundberg | Emergency Medicine | 601 East St. N, Elgin, ND 58533 | 2007-01-26 |
| 1629165915 | Jacobson Memorial Hospital Care Center | Skilled Nursing Facility | 601 E Street N, Elgin, ND 58533 | 2006-10-06 |
| 1013012327 | Family Vision Clinic LLP | Optometrist | 110 Main St N, Elgin, ND 58533 | 2006-09-13 |
| 1508161811 | Deepak Manmohan Goyal | Internal Medicine | 603 East St N, Elgin, ND 58533 | 2011-01-18 |
| 1821392093 | Home Town Health | Physician Assistant | 302 N Main St, Elgin, ND 58533 | 2011-01-03 |
| 1396895942 | Marcia Ketterling | Nurse Practitioner | 302 N Main St, Elgin, ND 58533 | 2007-01-12 |
| 1023036050 | Economy Drug Inc | Pharmacy | 201 N Main St, Elgin, ND 58533 | 2006-07-17 |
| Find all providers in zip 58533 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508205741 | Vibra Hospital of Fargo LLC | Long Term Care Hospital | 5225 23rd Ave S Fl 7, Fargo, ND 58104-7927 | 2013-06-20 |
| 1609852136 | Scci Hospitals of America Inc. | Long Term Care Hospital | 1720 University Dr S, Fargo, ND 58103-4940 | 2005-12-16 |
| 1760822803 | Vibra Hospital of Central Dakotas LLC | Long Term Care Hospital | 1000 18th St Nw, Mandan, ND 58554-1612 | 2013-07-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.