NPIMap

Organization Active NPI

Johnson County Hospital

Doing business as Adams Primary Care

  • Rural Health Clinic/Center
  • Adams, NE
National Provider Identifier
1003027442
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JOHNSON COUNTY HOSPITAL
Doing business as
Adams Primary Care
Practice address
620 Main St
Suite a
Adams, NE 68301-8277
Phone
(402) 988-2188
Fax
(402) 988-2203
NPI assigned
May 25, 2007
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNSON COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Jane Kent
Title
Ceo
Phone
(402) 335-3361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

620 Main St
Suite a
Adams, NE 68301-8277

Mailing address

PO Box 538
Tecumseh, NE 68450-0538
Phone (402) 335-2811

Other identifiers 1

IdentifierTypeStateIssuer
10025542000MedicaidNE

Other names 1

  • Adams Primary Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JohnsonCountyHospital@jchosp.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070829000811 NE Part A Provider - Rural Health Clinic 4688583644 Practice locations: Adams, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003027442. Details of each certification follow.

Rural health clinic certification: CCN 283499

Legal name
JOHNSON COUNTY HOSPITAL
Doing business as
ADAMS PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2007
Last certification
Dec 9, 2025
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
620 Main St
Ste a
Adams, NE 68301-8277
Related CCNs
281350

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0952343Adams Primary Care620 Main Street, Suite a, Adams, NE 68301Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory
Part of
Johnson County Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15810/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0abc5c50-19e6-4961-a76b-384f0caca068/

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly D Schaardt Individual W-2 Managing EmployeeClinic Manager Jun 1, 2011
Operational/Managerial ControlClinic Manager Jun 1, 2011
County of Johnson Organization, Tecumseh, NE Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Faith a Parde Individual Corporate DirectorBoard Member Nov 1, 2008
Randy L Baucke Individual Corporate Officer Dec 15, 2011
Corporate Director Apr 1, 1996
Mary Kent Individual Corporate Officer Feb 20, 2019
W-2 Managing Employee Feb 1, 2018
Operational/Managerial Control Feb 20, 2019
Harold E Kettelhake Individual Corporate Director Mar 31, 2000

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johnson County Hospital Home Health ServicesTecumseh, NE, CCN 287073 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1980

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1003027442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "684500538",
            "telephone_number": "402-335-2811",
            "fax_number": "402-335-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MAIN ST",
            "address_2": "SUITE A",
            "city": "ADAMS",
            "state": "NE",
            "postal_code": "683018277",
            "telephone_number": "402-988-2188",
            "fax_number": "402-988-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNSON COUNTY HOSPITAL",
        "enumeration_date": "2007-05-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-335-3361"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025542000",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JohnsonCountyHospital@jchosp.cernerdirect.com",
            "affiliation": "N",
            "address_1": "620 Main St",
            "address_2": "Suite A",
            "city": "Adams",
            "state": "NE",
            "country_code": "US",
            "postal_code": "683018277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adams Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adams Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Adams, NE

Sources for this page

Verify at the official NPI Registry.