NPIMap

Organization Active NPI

Labette County Medical Center

Doing business as Labette Health Erie Clinic

  • Rural Health Clinic/Center
  • Erie, KS
National Provider Identifier
1194723890
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LABETTE COUNTY MEDICAL CENTER
Doing business as
Labette Health Erie Clinic
Practice address
324 S Main St
Erie, KS 66733-1439
Phone
(620) 244-3291
Fax
(620) 244-5458
NPI assigned
Jul 7, 2005
Last updated
May 24, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
LABETTE COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Authorized official

Name
Thomas L Macaronas
Title
Cfo
Phone
(620) 820-5251

Specialties & licenses 1

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

Addresses

Primary practice location

324 S Main St
Erie, KS 66733-1439

Mailing address

1902 S Hwy 59 BLDG E
Parsons, KS 67357
Phone (620) 820-5889

Other names 1

  • Labette Health Erie Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031112000344 KS Part B Supplier - Clinic/Group Practice 5496664369 Receives reassigned benefits from 163 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Parsons, KS
O20170811002522 KS Part A Provider - Rural Health Clinic 5496664369 Practice locations: Erie, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194723890. Details of each certification follow.

Rural health clinic certification: CCN 178608

Legal name
LABETTE COUNTY MEDICAL CENTER
Doing business as
LABETTE HEALTH ERIE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 26, 2017
Last certification
Dec 26, 2017
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
324 S Main St
Erie, KS 66733-1439
Related CCNs
170120

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

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
17D2126526Labette Health Erie Clinic324 S Main Street, Erie, KS 66733Certificate of waiverFeb 27, 2027

National Provider Directory

National Provider Directory

Locations

324 S Main St
Erie, KS 66733
Phone (620) 244-3291

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Marna George Individual Corporate DirectorBoard Member Apr 21, 2003 100%
Delyna R Bohnenblust Individual Corporate DirectorBoard Member Jun 28, 2012 100%
Jill Thomas Individual Corporate DirectorBoard Member Feb 4, 2015 100%
Wayne R Gilmore Individual Corporate DirectorBoard Member Apr 25, 2013 100%
Ned Wall Individual Corporate DirectorBoard Member May 21, 2009 100%
Labette County Medical Center Organization, Parsons, KS Non-profit 5% Or Greater Direct Ownership Interest Mar 27, 2017 100%
Melissa Morris Individual Corporate DirectorBoard Member Apr 25, 2013 100%
Perry Sorrell Individual Corporate DirectorBoard Member Sep 11, 2003 100%
Brian Williams Individual Corporate OfficerPresident, Ceo Sep 2, 2015 100%
W-2 Managing EmployeePresident, Ceo Sep 2, 2015 100%
Robert Gibbs Individual Corporate DirectorBoard Member Apr 25, 2013 100%
Thomas L. Macaronas Individual Corporate OfficerVice President, Ceo, Coo Jul 12, 2004 100%
W-2 Managing EmployeeVice President, Cfo, Coo Jul 12, 2004 100%
Ronald L Leonard Individual Corporate DirectorBoard Member May 21, 2009 100%

Owners & managing parties with NPI records 18

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

View all 18

All facility ownership & control disclosures 13

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

FacilityTypeRoleSince
Labette HealthParsons, KS, CCN 170120 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Labette HealthParsons, KS, CCN 17U120 Hospital Operational/Managerial Control (5%) Jun 1, 2019
Labette Home HealthParsons, KS, CCN 177254 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 8, 2005
Labette Health St Paul ClinicSaint Paul, KS, CCN 173432 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1995
Labette Health Cherryvale ClinicCherryvale, KS, CCN 178570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 3, 2011
Labette Health Family Practice ClinicParsons, KS, CCN 178571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 3, 2011
Labette Health Independence ClinicIndependence, KS, CCN 178600 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2015
Labette Health Altamont ClinicAltamont, KS, CCN 178607 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 3, 2017
Labette Health Chanute Clinic and Express CareChanute, KS, CCN 178619 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2018
Labette Health Women's and Children's ClinicIndependence, KS, CCN 178618 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 15, 2018
Labette Health Oswego Clinic and Express CareOswego, KS, CCN 178624 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Labette Health Chetopa ClinicChetopa, KS, CCN 178623 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2019
Labette Health Pittsburg ClinicPittsburg, KS, CCN 178651 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 22, 2023

Owned or controlled facilities with NPI records 13

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

View all 13

Facilities with the same owner 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1194723890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 S HWY 59 BLDG E",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "67357",
            "telephone_number": "620-820-5889",
            "fax_number": "620-820-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 S MAIN ST",
            "city": "ERIE",
            "state": "KS",
            "postal_code": "667331439",
            "telephone_number": "620-244-3291",
            "fax_number": "620-244-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABETTE COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABETTE COUNTY MEDICAL CENTER",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "MACARONAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-820-5251"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Labette Health Erie Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, KS

Sources for this page

Verify at the official NPI Registry.