NPIMap

Organization Active NPI

Ellsworth County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Ellsworth, KS
National Provider Identifier
1063479145
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ELLSWORTH COUNTY MEDICAL CENTER
Practice address
1604 Aylward
Ellsworth, KS 67439-2541
Phone
(785) 472-3111
Fax
(785) 472-5760
NPI assigned
May 1, 2006
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
James Kirkbride
Title
Ceo
Phone
(785) 472-3111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

1604 Aylward
Ellsworth, KS 67439-2541

Mailing address

1604 Aylward
PO Box 87
Ellsworth, KS 67439-2541
Phone (785) 472-3111

Other identifiers 2

IdentifierTypeStateIssuer
001599OtherKSBC/BS SWINGBED
001599OtherKS(SWING) BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000616 KS Part A Provider - Critical Access Hospital 5395643357 1 other NPI on this enrollment
Practice locations: Ellsworth, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063479145. Details of each certification follow.

Hospital certification: CCN 17Z327

Legal name
ELLSWORTH COUNTY MEDICAL CENTER
Doing business as
ELLSWORTH COUNTY MEDICAL CENTER
Organization structure
OtherNon-profit
Incorporated
Aug 1, 1993 in KS
Enrollment address
1604 Aylward Ave
Ellsworth, KS 67439-2541
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ellsworth County Medica4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/fca01075-736c-4da3-b816-2ead95b5dce5/

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Clint Rogers Individual Corporate DirectorVice Chair Jan 1, 2021
Brandy Thornton Individual Corporate DirectorCfo Mar 19, 2024
W-2 Managing EmployeeCfo Mar 19, 2024
James Kirkbride Individual Corporate DirectorCeo Jan 1, 2019
W-2 Managing EmployeeCeo Jan 1, 2019
Karen Pauley Individual Corporate DirectorTreasurer Jan 1, 2021
Kenneth L Beneda Individual Corporate DirectorChairman Jan 1, 2021

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ecmc- Rural Health Clinic WilsonWilson, KS, CCN 178500 Rural health clinic Operational/Managerial Control (100%) Jul 29, 2005

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 3

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": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1063479145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 AYLWARD",
            "address_2": "PO BOX 87",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 AYLWARD",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KIRKBRIDE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-472-3111"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS  SWINGBED",
            "identifier": "001599",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "(SWING) BCBS",
            "identifier": "001599",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, KS

Sources for this page

Verify at the official NPI Registry.