NPIMap

Organization Active NPI

Greeley County Health Services, Inc

Doing business as Greeley County Family Practice Clinic

  • Rural Health Clinic/Center
  • Tribune, KS
National Provider Identifier
1124178397
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREELEY COUNTY HEALTH SERVICES, INC
Doing business as
Greeley County Family Practice Clinic
Practice address
321 E Harper
Tribune, KS 67879-0640
Phone
(620) 376-4251
Fax
(620) 376-2772
NPI assigned
Jan 11, 2007
Last updated
Feb 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Authorized official

Name
Sharon Rohr
Title
Clinic Manager
Phone
(620) 376-4251

Specialties & licenses 1

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

Addresses

Primary practice location

321 E Harper
Tribune, KS 67879-0640

Mailing address

PO Box 640
Tribune, KS 67879-0640
Phone (620) 376-4251

Other names 1

  • Greeley County Family Practice Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060112000647 KS Part A Provider - Rural Health Clinic 0042233496 Practice locations: Tribune, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124178397. Details of each certification follow.

Rural health clinic certification: CCN 178522

Legal name
GREELEY COUNTY HEALTH SERVICES INC
Doing business as
GREELEY COUNTY FAMILY PRACTICE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 23, 2004
Last certification
Oct 26, 2009
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
in KS
Enrollment address
321 E Harper St
Tribune, KS 67879-7708
Related CCNs
178522

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Greeley Cnty HLTH Serv Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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
Greeley County Health Services Inc Organization, Tribune, KS Non-profit Operational/Managerial Control Mar 8, 2006
Michael a Thon Individual Corporate DirectorDirector Jan 1, 2021 20%
Chris Dixon Individual Corporate Director Jan 1, 2015
Ben Fisher Individual Corporate DirectorDirector Jan 1, 2021 20%
Dan Hild Individual Corporate Director Jan 1, 2019
Linda Peterson Individual Corporate Director Jan 1, 2017
Trice Watts Individual Corporate OfficerCeo Jun 1, 2018
W-2 Managing EmployeeCfo Jun 1, 2018

Owners & managing parties with NPI records 4

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
Greeley County Health Services IncTribune, KS, CCN 17Z359 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2003
Wallace County Family Practice ClinicSharon Springs, KS, CCN 178525 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2006

Owned or controlled facilities with NPI records 2

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 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1124178397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "TRIBUNE",
            "state": "KS",
            "postal_code": "678790640",
            "telephone_number": "620-376-4251",
            "fax_number": "620-376-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E HARPER",
            "city": "TRIBUNE",
            "state": "KS",
            "postal_code": "678790640",
            "telephone_number": "620-376-4251",
            "fax_number": "620-376-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREELEY COUNTY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "ROHR",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "620-376-4251"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greeley County Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tribune, KS

Sources for this page

Verify at the official NPI Registry.