NPIMap

Organization Active NPI

Box Butte General Hospital

Doing business as Greater Nebraska Medical & Surgical Services - Hyannis

  • Rural Health Clinic/Center
  • Hyannis, NE
National Provider Identifier
1083782767
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BOX BUTTE GENERAL HOSPITAL
Doing business as
Greater Nebraska Medical & Surgical Services - Hyannis
Practice address
111 S Main St
Hyannis, NE 69350-9700
Phone
(308) 458-2436
Fax
(308) 458-2438
NPI assigned
Dec 1, 2006
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
BOX BUTTE GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Daniel W Griess
Title
Ceo
Phone
(308) 762-6660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

111 S Main St
Hyannis, NE 69350-9700

Mailing address

PO Box 810
Alliance, NE 69301-0810
Phone (308) 762-6660

Other identifiers 1

IdentifierTypeStateIssuer
10025169000MedicaidNE

Other names 1

  • Greater Nebraska Medical & Surgical Services - Hyannis Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030708000041 NE Part A Provider - Rural Health Clinic 9638089584 Practice locations: Hyannis, NE
O20031218000378 NE Part B Supplier - Clinic/Group Practice 9638089584 Receives reassigned benefits from 112 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alliance, NE; Hemingford, NE; Hyannis, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083782767. Details of each certification follow.

Rural health clinic certification: CCN 283467

Legal name
BOX BUTTE GENERAL HOSPITAL
Doing business as
GREATER NEBRASKA MEDICAL & SURGICAL SERVICES HYANNIS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 9, 2004
Last certification
Jul 23, 2024
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
111 S Main Ave
Hyannis, NE 69350-9700
Related CCNs
281360

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

Other NPIs with the same Medicare PAC ID 6

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.

National Provider Directory

National Provider Directory
Tax ID family
Hemingford Clinic5 organizations share this tax ID, including this one
Part of
Hemingford Clinic

Other organizations with this tax ID 4

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

Locations

2101 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-6660

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Lori a Mazanec Individual Corporate OfficerCeo Jan 1, 2014
W-2 Managing EmployeeCeo Nov 27, 2016
Tom E Cummings Individual Corporate DirectorTrustee Aug 14, 2017
County of Box Butte, State of Nebraska Organization, Alliance, NE Other Oct 1, 1976 100%
John Annen Individual Corporate DirectorTrustee Oct 1, 2013
Thomas J Furman Individual Corporate DirectorTrustee Oct 1, 2013
Barb Straub Individual Corporate DirectorTrustee Oct 1, 2020
Randy Langemeier Individual Corporate DirectorTrustee Oct 1, 2015

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Box Butte General HospitalAlliance, NE, CCN 28Z360 Hospital Other (100%) Oct 1, 1976

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1083782767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693010810",
            "telephone_number": "308-762-6660",
            "fax_number": "308-762-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S MAIN ST",
            "city": "HYANNIS",
            "state": "NE",
            "postal_code": "693509700",
            "telephone_number": "308-458-2436",
            "fax_number": "308-458-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOX BUTTE GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOX BUTTE GENERAL HOSPITAL",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "GRIESS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-762-6660"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025169000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Nebraska Medical & Surgical Services - Hyannis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hyannis, NE

Sources for this page

Verify at the official NPI Registry.