NPIMap

Organization Active NPI

Battle Mountain General Hospital

  • Critical Access Hospital
  • Battle Mountain, NV
National Provider Identifier
1104903103
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BATTLE MOUNTAIN GENERAL HOSPITAL
Practice address
535 S Humboldt St
Battle Mountain, NV 89820-1988
Phone
(775) 635-2550
Fax
(715) 635-9463
NPI assigned
Nov 1, 2006
Last updated
Mar 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Jason K Bleak
Title
Ceo
Phone
(775) 635-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

535 S Humboldt St
Battle Mountain, NV 89820-1988

Mailing address

535 S Humboldt St
Battle Mountain, NV 89820-1988
Phone (775) 635-2550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000113 NV Part B Supplier - Clinic/Group Practice 6901710144 Receives reassigned benefits from 17 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Battle Mountain, NV
O20171019002910 NV Part A Provider - Critical Access Hospital 6901710144 Practice locations: Battle Mountain, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104903103. Details of each certification follow.

Hospital certification: CCN 29Z303

Legal name
BATTLE MOUNTAIN GENERAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
535 S Humboldt St
Battle Mountain, NV 89820-1988
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Battle Mountain General Hosp10 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Cynthea J Fagg Individual Corporate DirectorController Apr 22, 2005
Jason Bleak Individual Corporate Officer Jan 15, 2018 100%
Corporate DirectorCeo Jan 15, 2018
Operational/Managerial ControlCeo Jan 15, 2018
Battle Mountain General Hospital Organization, Battle Mountain, NV Non-profit Operational/Managerial Control Aug 26, 2010 100%
Jodi Price Individual Corporate OfficerDirector of Business Services Jan 1, 2000 100%
Corporate DirectorDirector of Business Services Jan 1, 2000 100%
Operational/Managerial ControlDirector of Business Services Jan 1, 2000 100%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Battle Mountain General HospitalBattle Mountain, NV, CCN 291303 Hospital Operational/Managerial Control (100%) Aug 26, 2010
Battle Mountain ClinicBattle Mountain, NV, CCN 293984 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 16, 2007
May 16, 2007

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 17

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 17

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1104903103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S HUMBOLDT ST",
            "city": "BATTLE MOUNTAIN",
            "state": "NV",
            "postal_code": "898201988",
            "telephone_number": "775-635-2550",
            "fax_number": "715-635-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S HUMBOLDT ST",
            "city": "BATTLE MOUNTAIN",
            "state": "NV",
            "postal_code": "898201988",
            "telephone_number": "775-635-2550",
            "fax_number": "715-635-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATTLE MOUNTAIN GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "BLEAK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-635-2550"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Mountain, NV

Sources for this page

Verify at the official NPI Registry.