JACOBSON MEMORIAL HOSPITAL CARE CENTER
NPI 1003929944
Clinic/Center - Rural Health in Glen Ullin, ND
About Jacobson Memorial Hospital Care Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACOBSON MEMORIAL HOSPITAL CARE CENTER (NPI 1003929944), doing business as Glen Ullin Family Medical Clinic, is a healthcare organization registered as a rural health in Glen Ullin, North Dakota and active in the NPI registry since August 2006. The organization holds a CLIA Certificate of Compliance certificate valid through August 17, 2027 and lists Kristin Heid, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacobson Memorial Hospital Care Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
20Medicare enrollment records show 20 clinicians reassign Medicare billing to Jacobson Memorial Hospital Care Center, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (20)
Jamestown, ND 58401
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 35D0869325
Jacobson Memorial Hospital Care Center · Elgin, NDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacobson Memorial Hospital Care Center's NPI number?
The NPI number for Jacobson Memorial Hospital Care Center is 1003929944. It was assigned to this organization in the NPPES registry on August 16, 2006. The provider is doing business as Glen Ullin Family Medical Clinic.
Where is Jacobson Memorial Hospital Care Center located?
Jacobson Memorial Hospital Care Center is located at 602 Ash Ave E, Glen Ullin, ND 58631. The listed phone number is (701) 584-2792.
What is Jacobson Memorial Hospital Care Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Jacobson Memorial Hospital Care Center enrolled in Medicare?
Yes. Jacobson Memorial Hospital Care Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jacobson Memorial Hospital Care Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 20 clinicians in 4 Medicare specialties reassign their Medicare billing to Jacobson Memorial Hospital Care Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (12), Hospitalist (5) and Family Practice (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jacobson Memorial Hospital Care Center hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 35D0869325) is associated with this NPI, valid through August 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Jacobson Memorial Hospital Care Center accept?
Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Jacobson Memorial Hospital Care Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jacobson Memorial Hospital Care Center was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jacobson Memorial Hospital Care Center · NPI 1003929944
Rural Health organization in Glen Ullin, North Dakota. Organization record, active in the CMS NPPES registry since August 16, 2006.
## Identity
- **NPI:** 1003929944 (Entity type: Organization)
- **Enumerated:** August 16, 2006
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Also known as:** Glen Ullin Family Medical Clinic (Doing Business As)
- **Organization subpart:** Yes (part of Jacobson Memorial Hospital Care Center)
- **Authorized official:** Kristin Heid, CEO
## Practice location
- **Address:** 602 ASH AVE E, Glen Ullin, ND 58631
- **Phone:** (701) 584-2792
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 20 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Hospitalist (5), Family Practice (2) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 26, 2026
- **Other identifiers:** Other 06043003 (ND); Medicaid 1458638 (ND)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003929944) · Data from the CMS NPPES public registry.