NPIMap

Organization Active NPI

Franklin County Memorial Hospital

  • Rural Health Clinic/Center
  • Franklin, NE
National Provider Identifier
1164465829
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FRANKLIN COUNTY MEMORIAL HOSPITAL
Practice address
121 15TH Ave
Franklin, NE 68939-1043
Phone
(308) 425-6221
Fax
(308) 425-3164
NPI assigned
Jun 13, 2006
Organization subpart
Yes
Parent organization
FRANKLIN COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Authorized official

Name
Ms. Theresa Rizzo
Title
Administrator/Ceo
Phone
(308) 425-6221

Specialties & licenses 1

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

Addresses

Primary practice location

121 15TH Ave
Franklin, NE 68939-1043

Mailing address

1406 Q St
Franklin, NE 68939-1073
Phone (308) 425-6221

Other names 1

  • FCMH Pool 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
O20050812000854 NE Part A Provider - Rural Health Clinic 9537055975 Practice locations: Franklin, NE

Rural health clinic certification: CCN 283999

Legal name
FRANKLIN COUNTY MEMORIAL HOSPITAL
Doing business as
FCMH POOL MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 21, 1993
Last certification
Dec 22, 2020
Ownership / control type
2A
Organization structure
OtherNon-profit
Enrollment address
121 15TH Ave
Franklin, NE 68939-1043
Related CCNs
281311

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

Other NPIs with the same Medicare PAC ID 1

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
28D0456140FCMH Pool Medical Clinic121 15TH Avenue, Franklin, NE 68939Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Part of
FCMH Campbell Medical C

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jeffrey L Loschen Individual Corporate Officer Jul 1, 2006
Corporate Director Jul 1, 2002
Michael C Yelken Individual Corporate Director Jun 1, 2023
Mary K Minnick Individual Corporate Director Jun 1, 2023
Jerry L Fouts Individual Corporate Officer Jul 1, 2017
Corporate Director Jul 1, 2012
Bryon L Detlefsen Individual Corporate Director Jul 1, 2019
Theresa Rizzo Individual Corporate OfficerAdministrator/Ceo Sep 1, 2015
W-2 Managing EmployeeAdministrator/Ceo Sep 1, 2015
Operational/Managerial ControlAdministrator/Ceo Sep 1, 2015
Scott J Wewel Individual W-2 Managing EmployeeMD; Feb 1, 2023
Operational/Managerial ControlMedical Director Feb 1, 2023
Trisha L Slocum Individual W-2 Managing EmployeeAd;Director Nursing/Clinic Director Jun 1, 2016
Operational/Managerial ControlDirector Nursing/Clinic Director Jun 1, 2016

Owners & managing parties with NPI records 1

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

  • Scott Wewel, MD
    • Family Medicine Physician
    • Kansas City, KS
    • NPI 1487090056

    Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1164465829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 Q ST",
            "city": "FRANKLIN",
            "state": "NE",
            "postal_code": "689391073",
            "telephone_number": "308-425-6221",
            "fax_number": "308-425-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 15TH AVE",
            "city": "FRANKLIN",
            "state": "NE",
            "postal_code": "689391043",
            "telephone_number": "308-425-6221",
            "fax_number": "308-425-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANKLIN COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "RIZZO",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "308-425-6221",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCMH Pool Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FCMH Pool Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, NE

Sources for this page

Verify at the official NPI Registry.