Perkins County Hospital District
Organization Active NPI Rural Health Clinic/Center · Ogallala, NE
NPI 1033767967 · NPPES record last updated Sep 4, 2019
Key facts
- NPI
- 1033767967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- PERKINS COUNTY HOSPITAL DISTRICT
- Practice address
- 221 E 10TH St
Ogallala, NE 69153-1425 - Phone
- (308) 284-8421
- NPI assigned
- Sep 4, 2019
- Organization subpart
- No
Authorized official
- Name
- Neil Hilton
- Title
- Ceo
- Phone
- (308) 352-7245
Owners & managing parties with NPI records 4
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 5
Related certifications (CCN) 1
Practitioners 22
-
Shane B Banks, D.O.
-
Eileen Annette Bonin, APRN
-
Kelly Leigh Bullock, D.O.
-
John Matthew Byrd, M.D.
-
Carol S. Cornelius, PA-C
-
Traci E Draucker, PA-C
-
Justin Engberg, MD
-
Shannon Fisher, PA-C
-
Julie Kuskie, APRN
-
Marilyn McDaniel, APRN
-
Pamela L Murphy, CRNA
-
Crystal Lynn Orr, PA-C
-
Carol Mary Packard, PHYSICIAN ASSISTANT
-
Angela Mae Patrick, APRN
-
Tamara L. Robbins, M.D.
-
Lauren Sexson, APRN
-
Bradley A Wiesner, CRNA
-
Brian D Holmgren, PA
-
Eric Verploeg, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Rural health clinic certification: CCN 288555
- Legal name
- PERKINS COUNTY HOSPITAL DISTRICT
- Doing business as
- PERKINS COUNTY FAMILY CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Apr 26, 2021
- Last certification
- Jul 17, 2024
- Ownership / control type
- Non-profit – church related
- Organization structure
- Government · Non-profit
- Enrollment address
- 221 E 10TH St
Ogallala, NE 69153-1425 - Related CCNs
- 281356
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Brent Gloy |
Corporate Director |
Jul 1, 2024 | |
| Perkins County Hospital District |
5% Or Greater Direct Ownership Interest | Nov 1, 2019 | 100% |
| Operational/Managerial Control | Nov 1, 2019 | 100% | |
| Melissa Wilson |
Corporate Director |
Jul 1, 2022 | |
| Brett Franklin |
Corporate Director |
Jul 1, 2024 | |
| Amy Glinn |
W-2 Managing Employee |
Nov 1, 2019 | |
| Operational/Managerial Control |
Nov 1, 2019 | ||
| Marcia Shalla |
Corporate Director |
Jul 1, 2022 | |
| Neil Hilton |
Corporate Officer |
Nov 1, 2019 | |
| W-2 Managing Employee | Nov 1, 2019 | ||
| Operational/Managerial Control | Nov 1, 2019 | ||
| Jeff Skeels |
Corporate Director |
Jul 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191031002113 | NE | Part a Provider - Rural Health Clinic | 0840109823 | Practice locations: Ogallala, NE |
National Provider Directory
- Tax ID family
- Grant Medical Clinic
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/perkcod-b23e0775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
221 E 10TH St
Ogallala, NE 69153-1425
Mailing address
900 Lincoln Ave
Grant, NE 69140-3095
Phone (308) 352-7200
Other names
- PERKINS COUNTY FAMILY CLINIC
Other providers in Ogallala, NE
- Ashlynn Rae Orr
- Crystal Lynn Orr
- Carol Mary Packard
- John J Paloucek
- Monica Rachelle Patin
- Perkins County Hospital District
- Tara Dawn Perlinger
- Mara Peters
- Shalee Pollard
- Melinda Pearl Potter
All providers in Ogallala, NE · Rural Health Clinic/Center in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.