MCKENZIE COUNTY HEALTHCARE SYSTEMS INC (NPI# 1619998358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619998358 |
| Entity Type | Organization |
| Organization Name | MCKENZIE COUNTY HEALTHCARE SYSTEMS INC |
| Other Organization Name | GOOD SHEPHERD HOME |
| Practice Address |
709 4th Ave Ne Watford City ND 58854-7628 |
| Practice Telephone | 7014442331 |
| Practice Fax Number | 7014444629 |
| Mailing Telephone | 7014442331 |
| Mailing Fax Number | 7014444629 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-12-13 |
| Authorized Official Name | DANIEL R KELLY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7018423000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCKENZIE COUNTY HEALTHCARE SYSTEMS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30449 | 05 |
| Other Name | Type Code |
|---|---|
| Good Shepherd Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427079854 | Mckenzie County Healthcare Systems Inc | Medicare Defined Swing Bed Unit | 516 North Main Street, Watford City, ND 58854 | 2006-07-21 |
| 1083224067 | Mckenzie County Healthcare Systems Inc | Family Medicine | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1548870520 | Mckenzie County Healthcare Systems Inc | Non-Pharmacy Dispensing Site | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1932385705 | Mckenzie County Healthcare Systems Inc | Pharmacy | 516 N Main St, Watford City, ND 58854-7310 | 2008-01-11 |
| 1063420495 | Mckenzie County Healthcare Systems Inc | Clinic/Center | 525 N Main St, Watford City, ND 58854-7313 | 2006-08-03 |
| 1689698193 | Mckenzie County Healthcare Systems Inc | Custodial Care Facility | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-27 |
| 1457374217 | Mckenzie County Healthcare Systems Inc | Clinic/Center | 525 N Main St, Watford City, ND 58854-7313 | 2006-07-25 |
| 1518988948 | Mckenzie County Healthcare Systems Inc | General Acute Care Hospital | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-21 |
| Street Address |
709 4TH AVE NE |
| City | WATFORD CITY |
| State | ND |
| Zip Code | 58854-7628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224067 | Mckenzie County Healthcare Systems Inc | Family Medicine | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1548870520 | Mckenzie County Healthcare Systems Inc | Non-Pharmacy Dispensing Site | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1184241507 | Mckayla Haugeberg | Physical Therapist | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-07-01 |
| 1255964698 | Amanda Marie Mitchell | Nurse Practitioner | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-02-13 |
| 1902440449 | Christy Marie Moe | Nurse Practitioner | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2019-10-28 |
| 1508179854 | Tracy Beth Tomjack | Family Medicine | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2010-07-15 |
| 1689698193 | Mckenzie County Healthcare Systems Inc | Custodial Care Facility | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-27 |
| 1518988948 | Mckenzie County Healthcare Systems Inc | General Acute Care Hospital | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306308101 | Summit Silver Creek, LLC | Substance Abuse Rehabilitation Facility | 2046 125th Ave, Watford City, ND 58854 | 2019-04-02 |
| 1548716285 | Mckenzie County Social Services | Case Management | 201 5th St. Nw, Ste. 790, Watford City, MS 58854 | 2016-09-01 |
| 1275923450 | Jennifer Fleck | Nurse Practitioner | 118 8th Street Ne, Watford City, ND 58854 | 2015-01-27 |
| 1437497625 | Aaron Burke Patchen | Chiropractor | 105 9th Ave Se, Ste 3, Watford City, ND 58854 | 2013-01-22 |
| 1164703559 | Narek Ovsepian | Dentist | 324 3rd St Nw, Watford City, ND 58854 | 2011-08-30 |
| 1861614489 | Marilyn Beth Pierce | Physical Therapist | 3272 127th Avenue Nw, Watford City, ND 58854 | 2007-05-03 |
| 1710063771 | Gary L Trauger | Chiropractor | 105 2nd Ave Ne, Watford City, ND 58854 | 2006-10-31 |
| 1518056142 | Mckenzie County Ambulance Service | Ambulance | 204 3rd Ave Ne, Watford City, ND 58854 | 2006-10-12 |
| 1427079854 | Mckenzie County Healthcare Systems Inc | Medicare Defined Swing Bed Unit | 516 North Main Street, Watford City, ND 58854 | 2006-07-21 |
| 1184645533 | Gary W Ramage | General Practice | 525 North Main Street, Watford City, ND 58854 | 2006-07-21 |
| Find all providers in zip 58854 | ||||
| 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 |
|---|---|---|---|---|
| 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 | WATFORD CITY |
| Zip Code | 58854 |
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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.