NPIMap

Organization Active NPI

Sheridan County Hospital

  • Critical Access Hospital
  • Hoxie, KS
National Provider Identifier
1184635229
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H09001 Issued in KS
Legal business name
SHERIDAN COUNTY HOSPITAL
Practice address
826 18TH St
Hoxie, KS 67740-0167
Phone
(785) 675-3281
Fax
(785) 675-3840
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Authorized official

Name
Christine L Niblock
Title
Chief Financial Officer
Phone
(785) 675-3281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H09001 KS Primary

Addresses

Primary practice location

826 18TH St
Hoxie, KS 67740-0167

Mailing address

PO Box 167
826 18TH St
Hoxie, KS 67740-0167
Phone (785) 675-3281

Other identifiers 1

IdentifierTypeStateIssuer
100080380AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000258 KS Part A Provider - Critical Access Hospital 7416842380 Receives reassigned benefits from 2 practitioners
Practice locations: Hoxie, KS

Hospital certification: CCN 171347

Legal name
SHERIDAN COUNTY HOSPITAL
Doing business as
SHERIDAN COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 19, 2002
Last certification
Sep 30, 2016
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
826 18TH St
Box 167
Hoxie, KS 67740-0167
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Sheridan County HospitalCCN 171347
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Hoxie Medical Clinic10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

826 18th St
Ste A
Hoxie, KS 67740
Phone (785) 675-3018

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Marcella Cameron Individual Other Jan 1, 2022
Rebecca Bird Individual Operational/Managerial ControlAccount Manager Apr 26, 2021
Chad Koster Individual Corporate DirectorCeo Feb 10, 2022 100%
W-2 Managing EmployeeCeo Feb 10, 2022
Renae Kersenbrock Individual Other Jan 1, 2023
Joy Bretz Individual Corporate OfficerHospital Board Member Apr 7, 2015
Leanna Sloan Individual Corporate OfficerHospital Board Member Apr 14, 2015

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hoxie Medical ClinicHoxie, KS, CCN 171863 Federally qualified health center Other (100%) Jan 1, 1966
Selden Community ClinicSelden, KS, CCN 171868 Federally qualified health center Operational/Managerial Control (100%)
Other (100%)		 Jun 1, 2015
Jun 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

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

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266192000000",
    "number": "1184635229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 167",
            "address_2": "826 18TH ST",
            "city": "HOXIE",
            "state": "KS",
            "postal_code": "677400167",
            "telephone_number": "785-675-3281",
            "fax_number": "785-675-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 18TH ST",
            "city": "HOXIE",
            "state": "KS",
            "postal_code": "677400167",
            "telephone_number": "785-675-3281",
            "fax_number": "785-675-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2010-02-15",
        "status": "A",
        "authorized_official_last_name": "NIBLOCK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "785-675-3281"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KS",
            "license": "H09001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080380A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoxie, KS

Sources for this page

Verify at the official NPI Registry.