NPIMap

Organization Active NPI

Antelope Memorial Hospital

  • Critical Access Hospital
  • Neligh, NE
National Provider Identifier
1083790893
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
020001 Issued in NE
Legal business name
ANTELOPE MEMORIAL HOSPITAL
Practice address
102 W 9TH St
Neligh, NE 68756-1114
Phone
(402) 887-4151
Fax
(402) 887-4092
NPI assigned
Oct 27, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
Diane M Brugger
Title
Administrator
Phone
(402) 887-4151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 020001 NE Primary

Addresses

Primary practice location

102 W 9TH St
Neligh, NE 68756-1114

Mailing address

PO Box 229
Neligh, NE 68756-0229
Phone (402) 887-4151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070203000095 NE Part A Provider - Critical Access Hospital 5496733156 Receives reassigned benefits from 20 practitioners
Practice locations: Neligh, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083790893. Details of each certification follow.

Hospital certification: CCN 281326

Legal name
ANTELOPE MEMORIAL HOSPITAL
Doing business as
ANTELOPE MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 1, 2000
Last certification
Apr 11, 2024
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 3, 1952 in NE
Enrollment address
102 W 9TH St
Neligh, NE 68756-1114
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Antelope Memorial HospitalCCN 281326 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
A M H Family Practice10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kelli Osborn Individual W-2 Managing EmployeeChief of Staff Jun 24, 2020
Operational/Managerial ControlChief of Staff Jun 24, 2020
Maury M Soper Individual Corporate Director Mar 24, 2021
Gordon W Shrader Individual Corporate Director May 1, 2009
David P Sullivan Individual Corporate Director Jun 1, 1999
Jon Schilling Individual Corporate Director Nov 24, 2015
Samantha Stoltz Individual Corporate Director Jul 28, 2015
John J Mlnarik Individual Corporate Officer Nov 1, 2009
Corporate Director Feb 1, 1985
Russell M Vetick Individual Corporate Director Jul 24, 2018
Thomas J Zwingman Individual Corporate Director Nov 28, 2018
Diane M Brugger Individual Corporate OfficerAdministrator Mar 1, 2019
W-2 Managing EmployeeAdministrator Mar 1, 2019
Operational/Managerial ControlAdministrator Mar 1, 2019
Christopher W Twibell Individual Corporate Director May 1, 2009
James E Meuret Individual Corporate Officer Jul 29, 2020
Corporate Director Aug 1, 1995

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

Affiliated clinicians 58

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

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1083790893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 229",
            "city": "NELIGH",
            "state": "NE",
            "postal_code": "687560229",
            "telephone_number": "402-887-4151",
            "fax_number": "402-887-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W 9TH ST",
            "city": "NELIGH",
            "state": "NE",
            "postal_code": "687561114",
            "telephone_number": "402-887-4151",
            "fax_number": "402-887-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "BRUGGER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-887-4151"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "020001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neligh, NE

Sources for this page

Verify at the official NPI Registry.