NPIMap

Organization Active NPI

Ellsworth County Medical Center

  • Critical Access Hospital
  • Ellsworth, KS
National Provider Identifier
1083614028
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H027001 Issued in KS
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
Jul 29, 2005
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
Critical Access Hospital 282NC0060X H027001 KS 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 4

IdentifierTypeStateIssuer
30003930830005MedicaidKS
836OtherBLUE CROSS/BLUE SHIELD
836OtherKSBCBS
633850OtherFIRSTGUARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040716000216 KS Part B Supplier - Clinic/Group Practice 5395643357 Receives reassigned benefits from 35 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellsworth, KS
O20070227000678 KS Part A Provider - Critical Access Hospital 5395643357 Receives reassigned benefits from 36 practitioners
Practice locations: Ellsworth, KS
O20070228000616 KS Part A Provider - Critical Access Hospital 5395643357 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellsworth, KS

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1083614028. Details of each certification follow.

Hospital certification: CCN 171327

Legal name
ELLSWORTH COUNTY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2000
Last certification
Feb 6, 2019
Beds
18
Ownership / control type
Private (for profit)
Organization structure
OtherNon-profit
Incorporated
Aug 1, 1993 in KS
Enrollment address
1604 Aylward Ave
Ellsworth, KS 67439-2541
Other Hospital Practice Location

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 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ellsworth County Medical CenterCCN 171327 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

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 36

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.

View all 36

Affiliated clinicians 55

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

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1083614028",
    "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": "2005-07-29",
        "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KS",
            "license": "H027001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003930830005",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "836",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "836",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "633850",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, KS

Sources for this page

Verify at the official NPI Registry.