NPIMap

Organization Active NPI

Beatrice Community Hospital & Health Center Inc

  • Rural Health Clinic/Center
  • Beatrice, NE
National Provider Identifier
1073608204
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC
Practice address
4800 Hospital Pkwy Ste 202
Beatrice, NE 68310-6906
Phone
(402) 228-3344
Fax
(402) 223-7299
NPI assigned
Oct 4, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Chad Jurgens
Title
Cfo
Phone
(402) 223-7224

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X

Addresses

Primary practice location

4800 Hospital Pkwy Ste 202
Beatrice, NE 68310-6906

Mailing address

PO Box 278
Beatrice, NE 68310-0278
Phone (402) 228-3344

Other identifiers 5

IdentifierTypeStateIssuer
07-00344OtherNEUNITED HEALTHCARE #
1201520001OtherNECIGNA MEDICARE
20 862062 01MedicaidKS
7785040MedicaidSD
31607OtherNEBLUE CROSS #

Other names 1

  • THE BEATRICE WOMEN'S AND CHILDREN'S CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090625000304 NE Part A Provider - Rural Health Clinic 1951208222 Practice locations: Beatrice, NE
O20121214000477 NE Part B Supplier - Clinic/Group Practice 1951208222 Receives reassigned benefits from 106 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beatrice, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073608204. Details of each certification follow.

Rural health clinic certification: CCN 288504

Legal name
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC
Doing business as
THE BEATRICE WOMEN'S AND CHILDREN'S CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2010
Last certification
Oct 25, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1968 in NE
Enrollment address
4800 Hospital Pkwy
Ste 202
Beatrice, NE 68310-6906
Related CCNs
281364

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 2

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

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
28D0876021Beatrice Women's & Children's Clinic4800 Hospital Parkway, Suite 202, Beatrice, NE 68310Provider-performed microscopySep 14, 2026

National Provider Directory

National Provider Directory
Part of
Beatrice Community Inc

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Richard Haraldson Individual Corporate OfficerCeo Jan 1, 2018
W-2 Managing EmployeeCeo Jan 1, 2018
Ryan Trauernicht Individual Corporate DirectorBoard Member Jan 1, 2021
Chad E Jurgens Individual W-2 Managing EmployeeCfo Nov 18, 2019
Operational/Managerial ControlCfo Nov 18, 2019
Rodney Ensz Individual Corporate OfficerBoard Secretary Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2019
Deanne Caspers Moon Individual Corporate DirectorBoard Member Jan 1, 2017
Steve Sandman Individual Corporate OfficerBoard Chair Jan 1, 2016
Corporate DirectorBoard Member Jan 1, 2016
Le Roy J Janzen Individual Corporate OfficerBoard Vice Chair Jan 1, 2008
Corporate DirectorBoard Member Jan 1, 2008
Jennifer Elliott Individual Corporate DirectorBoard Member Jan 1, 2022
Susan Hartley Individual Corporate DirectorBoard Member Jan 1, 2021
Deann C Paulson Individual Corporate DirectorBoard Member Jan 1, 2021
Craig Zarybnicky Individual Corporate DirectorBoard Member Jan 1, 2020
Brenda McNiff Individual Corporate DirectorBoard Member Jan 31, 2014
Benjamin J Thayer Individual Corporate DirectorBoard Member Jan 1, 2021
Bruce Vitosh Individual Corporate OfficerBoard Treasurer Jan 1, 2016
Corporate DirectorBoard Member Jan 1, 2016

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1073608204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683100278",
            "telephone_number": "402-228-3344",
            "fax_number": "402-223-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HOSPITAL PKWY STE 202",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683106906",
            "telephone_number": "402-228-3344",
            "fax_number": "402-223-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "JURGENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-223-7224"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE #",
            "identifier": "07-00344",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "1201520001",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20 862062 01",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7785040",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS #",
            "identifier": "31607",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE BEATRICE WOMEN'S AND CHILDREN'S CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beatrice, NE

Sources for this page

Verify at the official NPI Registry.