Community Medical Center, Inc
Organization Active NPI Family Medicine Physician · Falls City, NE
NPI 1194767285 · NPPES record last updated Mar 25, 2025
Key facts
- NPI
- 1194767285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- COMMUNITY MEDICAL CENTER, INC
- Practice address
- 3307 Bill Schock Blvd
Falls City, NE 68355-2428 - Phone
- (402) 245-4475
- Fax
- (402) 245-6651
- NPI assigned
- Jun 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Ryan Chadwick Larsen
- Title
- Chief Executive Officer
- Phone
- (402) 245-6500
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 3
Related certifications (CCN) 1
Practitioners 12
-
Gayle Lynette Keller, APRN
-
Sandra Sue Catlin, APRN
-
Alyssa Finck, D.O.
-
Mary C Jones, P.A.
-
Carrie Ann Ramsey, PA-C
-
Amy Reafleng, APRN
-
Adam R Streit, D.O.
-
Justin Ryan Westengaard, M.D.
-
David Eugene Borg, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D0454747 | Family Medicine | Compliance | Jun 13, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NE
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
- Corporation · Non-profit
- Incorporated
- Jul 20, 1955 in NE
- Enrollment address
- 3307 Barada Street
Falls City, NE 68355-2470 - Related CCNs
- 281352
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Ryan Larsen |
Corporate Officer |
Sep 6, 2005 | |
| Nicole Mason |
Operational/Managerial Control |
Aug 1, 2020 | |
| Bonnie Kanel |
Operational/Managerial Control |
Aug 1, 2020 | |
| Richard Sicora |
Corporate Officer |
Aug 25, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
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
- Family Medicine
Other providers in Falls City, NE
- Chaney Furniture Company
- Jennifer Choate
- Trischa Joann Clow
- Deanna Cochran
- Community Medical Center, Inc
- Community Medical Center, Inc.
- Community Medical Center, Inc.
- Niki Deeds
- Kami Sue Donahoo
- Empowerher & Wellness
All providers in Falls City, NE · Family Medicine Physician in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.