NPIMap

Organization Active NPI

Rural Health Resources of Jackson Co Inc

Doing business as Family Practice Associates

  • Rural Health Clinic/Center
  • Wetmore, KS
National Provider Identifier
1003152430
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
RURAL HEALTH RESOURCES OF JACKSON CO INC
Doing business as
Family Practice Associates
Wetmore Family Medicine
Practice address
323 2ND St
Wetmore, KS 66550-9618
Phone
(785) 866-4775
Fax
(785) 866-4204
NPI assigned
Dec 12, 2012
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Ms. Carrie L Saia
Title
Chief Executive Officer
Phone
(785) 364-2116

Specialties & licenses 1

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

Addresses

Primary practice location

323 2ND St
Wetmore, KS 66550-9618

Mailing address

1110 Columbine Dr Ste 100
Holton, KS 66436-8824
Phone (785) 364-2126

Other names 2

  • Family Practice Associates Doing business as
  • Wetmore Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130318000473 KS Part A Provider - Rural Health Clinic 7810807690 Practice locations: Wetmore, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003152430. Details of each certification follow.

Rural health clinic certification: CCN 178575

Legal name
RURAL HEALTH RESOURCES OF JACKSON CO INC
Doing business as
WETMORE FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 29, 1992
Last certification
Nov 13, 2012
Ownership / control type
1A
Most recent change of ownership
Jan 1, 2013 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Apr 17, 1997 in KS
Enrollment address
323 2ND St
Wetmore, KS 66550-9618
Related CCNs
171319

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

Other NPIs with the same Medicare PAC ID 7

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
17D2159533Rural Health Resources of Jackson Co Inc Dba323 2ND St, Wetmore, KS 66550Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Rural Health Resources Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

129 W 4th St
Holton, KS 66436
Phone (785) 364-9617

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Marilyn Watkins Individual Corporate Director Jan 1, 2021
Daniel Allen Brenner Individual Corporate OfficerVice Chair - Board of Directors Oct 23, 2018
Corporate Director Sep 25, 2013
Chad Bontrager Individual Corporate Director Oct 23, 2018
Bobbi J Ambrosio Individual Corporate Director Jul 1, 2021
Mark Aeschliman Individual Corporate Director Oct 23, 2018
Ladona M Schmidt Individual Corporate Director Jul 22, 2021
Carrie L Lutz Individual Corporate OfficerCeo Sep 26, 2012
W-2 Managing Employee Jun 1, 2015
Operational/Managerial ControlChief Executive Officer Jan 1, 2013 100%
Heather Schrick Individual Corporate Director Sep 25, 2019
Rural Health Resources of Jackson Co Inc Organization, Holton, KS Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Operational/Managerial Control Jan 1, 2013 100%
Gloria Stavropoulos Individual Corporate Director Sep 25, 2019

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Holton Community HospitalHolton, KS, CCN 171319 Hospital Operational/Managerial Control Apr 17, 1997
Holton Community HospitalHolton, KS, CCN 17Z319 Hospital Operational/Managerial Control Sep 26, 2012
Holton Community Hospital Home Health and Hospice AgencyHolton, KS, CCN 177272 Home health agency Operational/Managerial Control (100%) Apr 17, 1997
Rural Health Resources of Jackson Co IncHolton, KS, CCN 171544 Hospice Operational/Managerial Control (100%) Apr 17, 1997
Holton Family MedicineHolton, KS, CCN 178511 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 3, 2003
Hoyt Family MedicineHoyt, KS, CCN 178523 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 17, 1997
Apr 17, 1997

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1003152430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COLUMBINE DR STE 100",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "664368824",
            "telephone_number": "785-364-2126",
            "fax_number": "785-364-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 2ND ST",
            "city": "WETMORE",
            "state": "KS",
            "postal_code": "665509618",
            "telephone_number": "785-866-4775",
            "fax_number": "785-866-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH RESOURCES OF JACKSON CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "SAIA",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "785-364-2116",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Practice Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Practice Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wetmore Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wetmore, KS

Sources for this page

Verify at the official NPI Registry.