Battle Mountain General Hospital
Organization Active NPI Critical Access Hospital · Battle Mountain, NV
NPI 1104903103 · NPPES record last updated Mar 19, 2019
Key facts
- NPI
- 1104903103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 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
- Organization subpart
- No
Authorized official
- Name
- Jason K Bleak
- Title
- Ceo
- Phone
- (775) 635-2550
Owners & managing parties with NPI records 2
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 9
Related certifications (CCN) 3
Facilities with the same owner 2
Practitioners 18
-
Charloth Vanesa Bledsoe, APRN
-
Donald C Hansen, M.D.
-
Genadi Maltinski, M.D.
-
Lawrence J. Pellegrini, D.O.
-
Michele F Leary, D.O.
-
Paul D. Herman, M.D.
-
Katylynn B Hymas, PMHNP
-
Daniel Jones, DO
-
John F Trentini, M.D.
-
Cathryn Lue Beggs, FNP-C
-
Donald Richmond Bennett, M.D.
-
Jeffery G Gardner, M.D.
-
Katrina Krogh, MD
Affiliated clinicians 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Hospital certification: CCN 29Z303
- Legal name
- BATTLE MOUNTAIN GENERAL HOSPITAL
- Organization structure
- Other · Non-profit
- Enrollment address
- 535 S Humboldt St
Battle Mountain, NV 89820-1988
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Cynthea J Fagg |
Corporate Director |
Apr 22, 2005 | |
| Jason Bleak |
Corporate Officer | Jan 15, 2018 | 100% |
| Corporate Director |
Jan 15, 2018 | ||
| Operational/Managerial Control |
Jan 15, 2018 | ||
| Battle Mountain General Hospital |
Operational/Managerial Control | Aug 26, 2010 | 100% |
| Jodi Price |
Corporate Officer |
Jan 1, 2000 | 100% |
| Corporate Director |
Jan 1, 2000 | 100% | |
| Operational/Managerial Control |
Jan 1, 2000 | 100% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Battle Mountain General Hospital |
Hospital | Operational/Managerial Control (100%) | Aug 26, 2010 |
| Battle Mountain Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
May 16, 2007 May 16, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Battle Mountain General Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004408837 | Medicaid | NV |
Other providers in Battle Mountain, NV
- Agape Hospice and Palliative Care
- Alisha Andersen
- Bonnie Bare
- Battle Mountain General Hosp
- Battle Mountain General Hospital
- Battle Mountain General Hospital
- Battle Mountain General Hospital
- Battle Mountain General Hospital
- Battle Mountain General Hospital
- Battle Mountain General Hospital
All providers in Battle Mountain, NV · Critical Access Hospital in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2019. 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.