NPIMap

Organization Active NPI

Community Medical Center, Inc

Doing business as Family Medicine

  • Family Medicine Physician
  • Falls City, NE
National Provider Identifier
1194767285
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY MEDICAL CENTER, INC
Doing business as
Family Medicine
Practice address
3307 Bill Schock Blvd
Falls City, NE 68355-2428
Phone
(402) 245-4475
Fax
(402) 245-6651
NPI assigned
Jun 12, 2006
Last updated
Mar 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Ryan Chadwick Larsen
Title
Chief Executive Officer
Phone
(402) 245-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3307 Bill Schock Blvd
Falls City, NE 68355-2428

Mailing address

PO Box 399
Falls City, NE 68355-0399
Phone (402) 245-4475

Other names 1

  • Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040112000200 NE Part B Supplier - Clinic/Group Practice 6608776943 Receives reassigned benefits from 22 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Falls City, NE; Humboldt, NE
O20050726000064 NE Part A Provider - Rural Health Clinic 6608776943 Practice locations: Falls City, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194767285. Details of each certification follow.

Rural health clinic certification: CCN 283449

Legal name
COMMUNITY MEDICAL CENTER INC
Doing business as
FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 17, 1999
Last certification
Feb 3, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 20, 1955 in NE
Enrollment address
3307 Barada Street
Falls City, NE 68355-2470
Related CCNs
281352

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).

Other NPIs on the same Medicare enrollment 2

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
28D0454747Family Medicine3307 Bill Schock Boulevard, Falls City, NE 68355ComplianceJun 13, 2027

National Provider Directory

National Provider Directory

Locations

7601 Pioneers Blvd
Lincoln, NE 68506
Phone (402) 484-4475

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Ryan Larsen Individual Corporate OfficerCeo Sep 6, 2005
Nicole Mason Individual Operational/Managerial ControlChairman of the Board of Directors Aug 1, 2020
Bonnie Kanel Individual Operational/Managerial ControlVP on the Board of Directors Aug 1, 2020
Richard Sicora Individual Corporate OfficerCfo Aug 25, 2020

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1194767285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "FALLS CITY",
            "state": "NE",
            "postal_code": "683550399",
            "telephone_number": "402-245-4475",
            "fax_number": "402-245-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 BILL SCHOCK BLVD",
            "city": "FALLS CITY",
            "state": "NE",
            "postal_code": "683552428",
            "telephone_number": "402-245-4475",
            "fax_number": "402-245-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "CHADWICK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "402-245-6500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falls City, NE

Sources for this page

Verify at the official NPI Registry.