COOPERSTOWN MEDICAL CENTER (NPI# 1285726067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285726067 |
| Entity Type | Organization |
| Organization Name | COOPERSTOWN MEDICAL CENTER |
| Other Organization Name | COOPERSTOWN MEDICAL CENTER NURSING HOME |
| Practice Address |
1200 Roberts Ave Ne Cooperstown ND 58425-7101 |
| Practice Telephone | 7017972221 |
| Mailing Telephone | 7017972221 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | GREGORY STOMP (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 7017972221 |
| Authorized Official Credential | RN, LNHA |
| Is Organization Subpart | Y |
| Parent Organization Name | COOPERSTOWN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1012A | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30095 | 05 | |
| ND | BLUE CROSS BLUE SHIELD ND | 1107 | 01 |
| Other Name | Type Code |
|---|---|
| Cooperstown Medical Center Nursing Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134304231 | Cooperstown Medical Center | Durable Medical Equipment & Medical Supplies | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2008-01-08 |
| 1962548214 | Cooperstown Medical Center | Clinic/Center | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2007-01-30 |
| 1376635151 | Cooperstown Medical Center | Medicare Defined Swing Bed Unit | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1235239229 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-22 |
| 1548378474 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| Street Address |
1200 ROBERTS AVE NE |
| City | COOPERSTOWN |
| State | ND |
| Zip Code | 58425-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851393144 | Brian Twete | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2005-06-01 |
| 1144500596 | Griggs County Nursing Home | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2011-08-17 |
| 1053645317 | Brooke Leigh Fredrickson | Dietitian, Registered | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2009-09-18 |
| 1134304231 | Cooperstown Medical Center | Durable Medical Equipment & Medical Supplies | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2008-01-08 |
| 1962548214 | Cooperstown Medical Center | Clinic/Center | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2007-01-30 |
| 1376635151 | Cooperstown Medical Center | Medicare Defined Swing Bed Unit | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1184716045 | Agassiz Dental Associates, PC | Dentist | 1200 Roberts Ave Ne, Cooperstown, ND 58425 | 2006-09-29 |
| 1235239229 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-22 |
| 1770691651 | Norman Leo Berthiaume | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| 1548378474 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932310315 | Outlook Chiropractic | Chiropractor | 605 8th St Nw, Cooperstown, ND 58425 | 2007-05-25 |
| 1972923373 | Cia Gronneberg | Social Worker | 912 Burrel Ave Se, Box 567, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1235559683 | Griggs County | Public Health or Welfare | 912 Burrel Ave Se, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1912099870 | Arlo D Neumiller | Dentist | 1200 Roberts Av Ne, Cooperstown, ND 58425-0569 | 2006-09-29 |
| 1821210154 | Leon Donald Paczkowski | Pharmacist | 848 Burrell Ave., Cooperstown, ND 58425-0627 | 2007-05-03 |
| 1558379248 | Pharmacists Associates LLC | Pharmacy | 901 Burrell Ave Se, Cooperstown, ND 58425-0627 | 2006-08-04 |
| 1982814497 | City of Cooperstown | Ambulance | 611 9th St. Ne, Cooperstown, ND 58425-0712 | 2007-05-23 |
| 1396258745 | Rachel Marie Dahl | Pharmacist | 901 Burrel Ave Sw, Cooperstown, ND 58425-0901 | 2017-11-08 |
| 1710473764 | Larissa Ann Haug | Physician Assistant | 1200 Roberts Avenue Ne, Cooperstown, ND 58425-7101 | 2018-07-02 |
| 1992051221 | Essential Chiropractic Pllc | Chiropractor | 402 4th St Sw, Cooperstown, ND 58425-7541 | 2012-07-24 |
| Find all providers in zip 58425 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811397995 | Ccrn Operator LLC | Skilled Nursing Facility | 128 Phoenix Mills Rd, Cooperstown, NY 13326-5716 | 2014-08-26 |
| 1891773701 | County of Otsego | Skilled Nursing Facility | 128 Phoenix Mills Cross Rd, Cooperstown, NY 13326-5716 | 2006-01-03 |
| 1972010601 | Otsego Snf Operations Assoc LLC | Skilled Nursing Facility | 128 Phoenix Mills Rd, Cooperstown, NY 13326-5716 | 2018-01-03 |
| 1205230711 | Ccrn Operator LLC | Skilled Nursing Facility | 128 Phoenix Mills Rd, Cooperstown, NY 13326-5716 | 2014-10-13 |
| 1144500596 | Griggs County Nursing Home | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2011-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760033997 | Oluwakemi Isokpan | Skilled Nursing Facility | 1323 Legion Ln W, West Fargo, ND 58078-8523 | 2019-09-29 |
| 1164809562 | Eventide Fargo LLC | Skilled Nursing Facility | 3225 51st St S, Fargo, ND 58104-7180 | 2015-05-05 |
| 1841691789 | Tufte Manor | Skilled Nursing Facility | 3300 Cherry St, Grand Forks, ND 58201-7634 | 2014-09-10 |
| 1861745838 | Benedictine Living Community of Wahpeton | Skilled Nursing Facility | 711 14th Avenue North, Wahpeton, ND 58075 | 2012-10-16 |
| 1215256078 | Eventide Jamestown LLC | Skilled Nursing Facility | 1300 2nd Pl Ne, Jamestown, ND 58401-3709 | 2010-05-19 |
| 1427371889 | Benedictine Living Communities-bismarck, Inc. | Skilled Nursing Facility | 4580 Coleman Street, Bismarck, ND 58503-0347 | 2010-03-12 |
| 1508197013 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 301 Lorrain Dr, Bismarck, ND 58503-0311 | 2010-01-22 |
| 1144485608 | Villa Maria | Skilled Nursing Facility | 3102 University Dr S, Fargo, ND 58103-6004 | 2008-07-24 |
| 1477737625 | Pat Sitzer | Skilled Nursing Facility | 751 1st St., Pat Sizer, Minto, ND 58261 | 2007-12-24 |
| 1205041985 | Benedictine Living Center of Garrison | Skilled Nursing Facility | 609 Fourth Ave Ne, Garrison, ND 58540-0219 | 2007-05-14 |
| Find all providers with the same taxonomy | ||||
| City | COOPERSTOWN |
| Zip Code | 58425 |
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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.