NPIMap

Organization Active NPI

Boone County Health Center

Doing business as St Edward Medical Clinic

  • Rural Health Clinic/Center
  • Saint Edward, NE
National Provider Identifier
1144119488
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BOONE COUNTY HEALTH CENTER
Doing business as
St Edward Medical Clinic
Practice address
1102 Water St
Saint Edward, NE 68660-4478
Phone
(402) 678-2232
NPI assigned
Jul 1, 2025
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BOONE COUNTY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Caleb K Poore
Title
Ceo
Phone
(402) 395-3213

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1102 Water St
Saint Edward, NE 68660-4478

Mailing address

PO Box 151
Albion, NE 68620-0151
Phone (402) 395-2191

Other names 1

  • ST EDWARD MEDICAL CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250909003115 NE Part A Provider - Rural Health Clinic 1254306178 Practice locations: Saint Edward, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144119488. Details of each certification follow.

Rural health clinic certification: CCN 288560

Legal name
BOONE COUNTY HEALTH CENTER
Doing business as
ST EDWARD MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 1, 2025
Last certification
Sep 8, 2021
Ownership / control type
1B
Organization structure
OtherNon-profit
Enrollment address
1102 Water St
Saint Edward, NE 68660-4478
Related CCNs
281334

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).

National Provider Directory

National Provider Directory
Tax ID family
Newmen Grove11 organizations share this tax ID, including this one
Part of
Newmen Grove

Other organizations with this tax ID 10

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

Locations

104 N 1st St
Newman Grove, NE 68758
Phone (402) 447-6214

301 N 13th St
Saint Edward, NE 68660
Phone (402) 678-2294

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Tony Kurtenbach Individual Corporate Director Jul 1, 2019
Bryant P Carlson Individual W-2 Managing EmployeeMD; Sep 1, 2025
Operational/Managerial ControlMedical Director Sep 1, 2025
Dana J Cox Individual Corporate Officer Aug 2, 2024
Corporate Director Jul 1, 2024
Caleb Poore Individual Corporate OfficerCeo Oct 16, 2023
W-2 Managing EmployeeCeo Oct 16, 2023
Operational/Managerial ControlCeo Oct 16, 2023
Kim Beierman Individual Corporate Officer Oct 26, 2021
Corporate Director Jul 1, 2015
Paul Groeteke Individual Corporate Officer Oct 25, 2016
Corporate Director Jul 1, 2015
Gary Stokes Individual Corporate Director Jul 1, 2025
Kristie L Stricklin Individual W-2 Managing EmployeeAd;VP of Clinic Services Jul 12, 2019
Operational/Managerial ControlVP of Clinic Services Jul 12, 2019
Rita a Liss Individual W-2 Managing EmployeeCfo Jul 1, 2017
Operational/Managerial ControlCfo Jul 1, 2017

Owners & managing parties with NPI records 1

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

Change-of-ownership history 1

DateEventCounterparty
Sep 1, 2025 Change of OwnershipThis provider was the buyer St. Edward Medical ClinicCCN 283863, NE, NPI 1225063266

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1144119488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "ALBION",
            "state": "NE",
            "postal_code": "686200151",
            "telephone_number": "402-395-2191",
            "fax_number": "402-395-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WATER ST",
            "city": "SAINT EDWARD",
            "state": "NE",
            "postal_code": "686604478",
            "telephone_number": "402-678-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE COUNTY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOONE COUNTY HEALTH CENTER",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "POORE",
        "authorized_official_first_name": "CALEB",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-395-3213"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST EDWARD MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Edward, NE

Sources for this page

Verify at the official NPI Registry.