NPIMap

Organization Active NPI

Memorial Health Care Systems

Doing business as Utica Family Medical Center

  • Rural Health Clinic/Center
  • Utica, NE
National Provider Identifier
1154400844
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MEMORIAL HEALTH CARE SYSTEMS
Doing business as
Utica Family Medical Center
Practice address
100 4TH St
Utica, NE 68456-6016
Phone
(402) 534-2081
Fax
(402) 534-2187
NPI assigned
Nov 3, 2006
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HEALTH CARE SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Mr. Gregory E. Jerger
Title
Cfo
Phone
(402) 646-4628

Specialties & licenses 1

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

Addresses

Primary practice location

100 4TH St
Utica, NE 68456-6016

Mailing address

250 N Columbia Ave
Seward, NE 68434-2248
Phone (402) 643-4800

Other names 1

  • Utica Family Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhcsseward@mhcs.medalliesdirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100209000511 NE Part A Provider - Rural Health Clinic 3274528989 Practice locations: Utica, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154400844. Details of each certification follow.

Rural health clinic certification: CCN 283994

Legal name
MEMORIAL HEALTH CARE SYSTEMS
Doing business as
UTICA FAMILY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 10, 1993
Last certification
Oct 27, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 9, 1947 in NE
Enrollment address
100 4TH St
Utica, NE 68456-6016
Related CCNs
281339

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

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0857446Utica Family Medical Center100 4TH Street, Utica, NE 68456Provider-performed microscopyJan 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital7 organizations share this tax ID, including this one
Part of
Memorial Hospital

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jill E Eberspacher Individual Corporate Director Jan 29, 2021
Roger Reamer Individual Corporate OfficerCeo Jun 25, 2014
W-2 Managing EmployeeCeo Jun 15, 2000
Operational/Managerial ControlCeo Jun 15, 2000
Trisha M Sams Individual W-2 Managing EmployeeMedical Director Jul 1, 2007
Operational/Managerial ControlMedical Director Jul 1, 2007
Lana R Daws Individual Corporate Director Jan 19, 2018
Michael E Tomes Individual Corporate Officer Jan 29, 2021
Corporate Director Jan 19, 2018
Gregory Jerger Individual Corporate OfficerCfo Jun 25, 2014
W-2 Managing EmployeeCfo Aug 27, 1992
Operational/Managerial ControlCfo Aug 27, 1992
Michael E Hecker Individual Corporate Officer Jan 19, 2018
Corporate Director Jan 27, 2017
Joseph Caldwell Individual W-2 Managing EmployeeClinic Administrator Dec 2, 2019
Operational/Managerial ControlClinic Administrator Dec 2, 2019
Kevin W Wingard Individual Corporate Director Jan 18, 2019
Bradley Perdue Individual Corporate Director Feb 22, 2023
Donna L Havener Individual Corporate Officer Apr 27, 2022
Corporate Director Jan 29, 2021

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1154400844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N COLUMBIA AVE",
            "city": "SEWARD",
            "state": "NE",
            "postal_code": "684342248",
            "telephone_number": "402-643-4800",
            "fax_number": "402-646-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 4TH ST",
            "city": "UTICA",
            "state": "NE",
            "postal_code": "684566016",
            "telephone_number": "402-534-2081",
            "fax_number": "402-534-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HEALTH CARE SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH CARE SYSTEMS",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "JERGER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-646-4628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhcsseward@mhcs.medalliesdirect.net",
            "affiliation": "N",
            "address_1": "300 N Columbia Ave",
            "city": "Seward",
            "state": "NE",
            "country_code": "US",
            "postal_code": "684342299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Utica Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Utica Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Utica, NE

Sources for this page

Verify at the official NPI Registry.