NPIMap

Organization Active NPI

Rural Health Resources of Jackson Co Inc

Doing business as Holton Community Hospital Home Health and Hospice Agency

  • Community Based Hospice Care Agency
  • Holton, KS
National Provider Identifier
1023017605
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
RURAL HEALTH RESOURCES OF JACKSON CO INC
Doing business as
Holton Community Hospital Home Health and Hospice Agency
Practice address
1100 Columbine Dr
Holton, KS 66436-8841
Phone
(785) 364-9617
Fax
(785) 364-9620
NPI assigned
Jul 18, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X KS Primary

Addresses

Primary practice location

1100 Columbine Dr
Holton, KS 66436-8841

Mailing address

1110 Columbine Dr
Holton, KS 66436-8824
Phone (785) 364-2116

Other identifiers 1

IdentifierTypeStateIssuer
100244350DMedicaidKS

Other names 1

  • Holton Community Hospital Home Health and Hospice Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000684 KS Part A Provider - Hospice 7810807690 Practice locations: Holton, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023017605. Details of each certification follow.

Hospice certification: CCN 171544

Legal name
RURAL HEALTH RESOURCES OF JACKSON CO INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 28, 2000
Last certification
Apr 8, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Enrollment address
1100 Columbine Dr
Holton, KS 66436-8824

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Holton Community Hosp Home Health & Hospice AgencyCCN 171544 · All quality measures
Ownership
Non-Profit
Certified
Nov 28, 2000
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Rural Health Resources of Jackson Co 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

429 W 4TH St
Holton, KS 66436

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 OfficerChair - Board of Directors Oct 23, 2018
Corporate DirectorVice Chair Board of Directors Aug 26, 2009
Mark Aeschliman Individual Corporate Director Oct 23, 2018
Ladona M Schmidt Individual Corporate Officer Sep 14, 2022
Carrie L Lutz Individual Corporate OfficerChief Executive Officer Sep 26, 2012
W-2 Managing Employee Jun 1, 2015
Operational/Managerial ControlChief Executive Officer Sep 26, 2012 100%
Heather Schrick Individual Corporate Director Dec 1, 2020
Rural Health Resources of Jackson Co Inc Organization, Holton, KS Non-profit Operational/Managerial Control Apr 17, 1997 100%
Gloria Stavropoulos Individual Corporate Director Dec 1, 2020

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
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
Wetmore Family MedicineWetmore, KS, CCN 178575 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2013
Jan 1, 2013

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

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023017605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COLUMBINE DR",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "664368824",
            "telephone_number": "785-364-2116",
            "fax_number": "785-364-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 COLUMBINE DR",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "664368841",
            "telephone_number": "785-364-9617",
            "fax_number": "785-364-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH RESOURCES OF JACKSON CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-28",
        "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": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244350D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holton Community Hospital Home Health and Hospice Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holton Community Hospital Home Health and Hospice Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holton, KS

Sources for this page

Verify at the official NPI Registry.