NPIMap

Organization Active NPI

Osawatomie State Hospital

Doing business as Adair Acute Care at Osawatomie State Hospital

  • Psychiatric Hospital
  • Osawatomie, KS
National Provider Identifier
1184071532
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
M061102 Issued in KS
Legal business name
OSAWATOMIE STATE HOSPITAL
Doing business as
Adair Acute Care at Osawatomie State Hospital
Practice address
500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone
(913) 755-7000
Fax
(913) 755-7127
NPI assigned
May 16, 2016
Last updated
Dec 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Ashley Byram, LMSW
Title
Superintendent
Phone
(913) 755-7073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X M061102 KS Primary

Addresses

Primary practice location

500 State Hospital Dr
Osawatomie, KS 66064-1813

Mailing address

500 State Hospital Dr
Osawatomie, KS 66064-1813
Phone (913) 755-7000

Other identifiers 1

IdentifierTypeStateIssuer
M061102OtherKSKANSAS DEPT OF HEALTH AND ENVIRONMENT

Other names 1

  • Adair Acute Care at Osawatomie State Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161024001728 KS Part A Provider - Hospital 5698053866 Practice locations: Osawatomie, KS
O20170920000777 KS Part B Supplier - Hospital Department(S) 5698053866 Receives reassigned benefits from 24 practitioners
Practice locations: Osawatomie, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184071532. Details of each certification follow.

Hospital certification: CCN 174022

Legal name
OSAWATOMIE STATE HOSPITAL
Doing business as
ADAIR ACUTE CARE AT OSAWATOMIE STATE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 15, 2017
Last certification
Dec 1, 2017
Beds
60
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
500 State Hospital Dr
Osawatomie, KS 66064-1813
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Adair Acute Care at Osawatomie State HospitalCCN 174022 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

500 State Hospital Dr
Osawatomie, KS 66064
Phone (913) 755-7000

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
Clinton Glidewell Individual W-2 Managing EmployeeCeo Sep 6, 2020
Operational/Managerial ControlCeo Sep 6, 2020
Rhonda Singer Individual W-2 Managing EmployeePublic Service Administrator Jul 15, 2016
State of Kansas-Accounting Services Organization, Topeka, KS 5% Or Greater Direct Ownership Interest Jul 15, 2016 100%
Operational/Managerial Control Jul 15, 2016 100%
Osawatomie State Hospital Organization, Osawatomie, KS 5% Or Greater Direct Ownership Interest Jul 15, 2016 100%
Operational/Managerial Control Jul 15, 2016 100%
Maria M Gustilo Individual W-2 Managing EmployeeClinical Director Jul 15, 2016
Ashley Byram Individual W-2 Managing EmployeeSuperintendent Aug 19, 2023 100%
Operational/Managerial ControlSuperintendent Aug 19, 2023 100%
Joddie Covey Individual W-2 Managing EmployeeBilling/Patient Accounts Oct 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.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1184071532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 STATE HOSPITAL DR",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641813",
            "telephone_number": "913-755-7000",
            "fax_number": "913-755-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STATE HOSPITAL DR",
            "city": "OSAWATOMIE",
            "state": "KS",
            "postal_code": "660641813",
            "telephone_number": "913-755-7000",
            "fax_number": "913-755-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSAWATOMIE STATE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "BYRAM",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "913-755-7073",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "KS",
            "license": "M061102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS DEPT OF HEALTH AND ENVIRONMENT",
            "identifier": "M061102",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adair Acute Care at Osawatomie State Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adair Acute Care at Osawatomie State Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osawatomie, KS

Sources for this page

Verify at the official NPI Registry.