William Newton Memorial Hospital
Organization Active NPI Rural Health Clinic/Center · Dexter, KS
NPI 1083633374 · NPPES record last updated Dec 19, 2011
Key facts
- NPI
- 1083633374
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 173433 (KS)
- Legal business name
- WILLIAM NEWTON MEMORIAL HOSPITAL
- Practice address
- 204 North Main
Dexter, KS 67038 - Phone
- (620) 876-5863
- Fax
- (620) 876-5865
- NPI assigned
- Jul 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- WILLIAM NEWTON MEMORIAL HOSPITAL
Authorized official
- Name
- Mrs. Faye E Melton
- Title
- Clinic Manager
- Phone
- (620) 758-2221
Owners & managing parties with NPI records 7
Owned or controlled facilities with NPI records 5
Other NPIs with the same Medicare PAC ID 7
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 45
-
Jennifer Akins, PA
-
Ryan Samuel Beard, M.D.
-
Jody J Bieker, MD
-
Hannah Bingham, MD
-
Alvin D. Bird, D.O.
-
Michelle Bloedel, CRNA
-
Patrick Russell Bloedel, M.D.
-
Erik Calderon, M.D.
-
Edward Theodore Duensing, NP-C
-
Hope Lee Guerrero, APRN, FNP
-
Lori Grim Harris, CRNA
-
Daniel J Hein, MD
-
Angela Rene Johnson, FNP-C
-
Anna Christine Kill, APRN
-
Heidi Elaine Koschwanez, MD, PHD
-
Tyson A Lacy, CRNA
-
Thomas Lyman, DPM
-
Cyrus M Munguti, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Rural health clinic certification: CCN 173433
- Legal name
- WILLIAM NEWTON MEMORIAL HOSPITAL
- Doing business as
- DEXTER COMMUNITY RURAL HEALTH CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 3, 1996
- Last certification
- Nov 9, 2018
- Ownership / control type
- Non-profit – church related
- Organization structure
- Government · Non-profit
- Incorporated
- Jun 21, 1995 in KS
- Enrollment address
- 204 N Main St
Dexter, KS 67038-3806 - Related CCNs
- 171383
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Brian James Barta |
Corporate Director |
Aug 1, 2018 | 100% |
| Operational/Managerial Control |
Aug 1, 2018 | ||
| Gary Brewer |
Corporate Officer | Jun 16, 2022 | |
| Joan Cales |
Corporate Officer |
Aug 1, 2011 | |
| Steve McSpadden |
Corporate Officer |
Sep 1, 2002 | |
| William Newton Memorial Hospital |
Operational/Managerial Control | Jan 3, 1996 | 100% |
| Diane Lawrence |
Corporate Officer |
Jun 1, 2014 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Moline Community Rural Health Clinic |
Rural health clinic | Operational/Managerial Control Other (100%) |
Jul 21, 1995 Jul 21, 1995 |
| Tallgrass RHC |
Rural health clinic | Operational/Managerial Control (100%) | Jun 5, 1995 |
| Health Professionals of Winfield |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2013 |
| William Newton Hillside Family Medicine |
Rural health clinic | Operational/Managerial Control (100%) | Dec 2, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170606001495 | KS | Part a Provider - Rural Health Clinic | 5294648937 | Practice locations: Dexter, KS |
National Provider Directory
- Part of
- Moline Community Rural
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 173433 | KS | Yes |
Addresses
Primary practice location
204 North Main
Dexter, KS 67038
Mailing address
PO Box 240
204 North Main
Dexter, KS 67038-0240
Phone (620) 876-5863
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100005090H | Medicaid | KS |
Other names
- Dexter Community Rural Health Clinic
Other providers in Dexter, KS
All providers in Dexter, 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 Dec 19, 2011. 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.