Adventhealth Ransom Memorial, Inc.
Organization Active NPI Rural Health Clinic/Center · Wellsville, KS
NPI 1043773591 · NPPES record last updated Jun 28, 2024
Key facts
- NPI
- 1043773591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ADVENTHEALTH RANSOM MEMORIAL, INC.
- Practice address
- 424 Main St
Wellsville, KS 66092-8878 - Phone
- (785) 883-4863
- NPI assigned
- Apr 11, 2019
- Organization subpart
- No
Authorized official
- Name
- Shawn Perry
- Title
- Cfo
- Phone
- (785) 229-8244
Owners & managing parties with NPI records 1
-
Kenneth J Frank, M.D.
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 2
Related certifications (CCN) 1
Change of ownership 1
Facilities with the same owner 88
Practitioners 40
-
Bridget M Abney, MD
-
Shane Jay Alford, PA
-
Shandon Wells Anderson, APRN-C
-
Katherine Arner, DNP
-
David Allen Cocanower, M.D.
-
Sara Rene Cunningham, ARNP
-
Dale D Dalenberg, M.D.
-
Michelle L Dew, MD
-
Edwin M. Galan, ARNP, FNP-C
-
Charles Patrick Garrick, LCP. LCAC, TTS
-
Kassandra Nicole Johns, APRN
-
Van L Jones, D.O.
-
Sara E Krueger, DO
-
Kevin M Latinis, M.D.
-
Kelsey Nicole Lewis, APRN
-
Adam Joseph Madl, DO
-
Jo Anna McCalla, MD
-
Rodney Tay McCalla, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Rural health clinic certification: CCN 178590
- Legal name
- ADVENTHEALTH RANSOM MEMORIAL INC
- Doing business as
- ADVENTHEALTH WELLSVILLE HEALTH PARK
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 9, 2015
- Last certification
- Sep 10, 2024
- Ownership / control type
- 2B
- Most recent change of ownership
- May 1, 2019 (1 total)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 424 Main St
Wellsville, KS 66092-8878 - Related CCNs
- 170014
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Janet Peters |
Corporate Officer |
Apr 30, 2019 | |
| Corporate Director |
Apr 30, 2019 | ||
| Shawn Perry |
Contracted Managing Employee |
Nov 27, 2023 | |
| Corporate Officer |
Nov 27, 2023 | ||
| Operational/Managerial Control |
Nov 27, 2023 | ||
| Jeffrey Graff |
Corporate Officer |
Apr 30, 2019 | |
| Brendan Johnson |
Contracted Managing Employee |
Jan 20, 2025 | |
| Corporate Officer |
Jan 20, 2025 | ||
| Corporate Director |
Jan 20, 2025 | ||
| Operational/Managerial Control |
Jan 20, 2025 | ||
| Stuart Wolzen |
Corporate Director |
Apr 30, 2019 | |
| Adventisit Health Mid-America Inc |
5% Or Greater Direct Ownership Interest | Jun 19, 2018 | 100% |
| Ryan Henningson |
Corporate Director |
Apr 8, 2024 | |
| Sam Huenergardt |
Corporate Officer |
Apr 30, 2019 | |
| Corporate Director |
Jun 19, 2018 | ||
| Michael Saunders |
Corporate Officer |
Apr 30, 2019 | |
| Adventist Health System Sunbelt Healthcare Corporation |
5% Or Greater Indirect Ownership Interest | Jun 19, 2018 | 100% |
| Ronald Carlson |
Corporate Director |
Apr 30, 2019 | |
| Kenneth J Frank |
Corporate Director |
Apr 30, 2019 | |
| William K Heinrich |
Corporate Officer |
Sep 30, 2021 | |
| Corporate Director |
Sep 30, 2021 | ||
| Lynn Addiscott |
Corporate Officer |
Sep 13, 2018 | |
| John Coen |
Corporate Director |
Apr 30, 2019 | |
| Dallas Purkeypile |
Corporate Officer |
May 1, 2020 | |
| Corporate Director |
Feb 4, 2020 | ||
| Adventist Health System Sunbelt Inc |
5% Or Greater Indirect Ownership Interest | Jun 19, 2018 | 100% |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| May 1, 2019 | Change of Ownership |
Wellsville Family Medical Clinic |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190503000317 | KS | Part a Provider - Rural Health Clinic | 4486996907 | Practice locations: Wellsville, KS |
National Provider Directory
- Tax ID family
- Adventhealth Ransom Mem Inc
Networks
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
424 Main St
Wellsville, KS 66092-8878
Mailing address
7315 E Frontage Rd Ste 202
Merriam, KS 66204-1658
Other providers in Wellsville, KS
All providers in Wellsville, KS · Rural Health Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2024. 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.