Kearney Co Health Services
Organization Active NPI Rural Health Clinic/Center · Minden, NE
NPI 1205977873 · NPPES record last updated Oct 9, 2023
Key facts
- NPI
- 1205977873
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- KEARNEY CO HEALTH SERVICES
- Practice address
- 727 E 1St St
Minden, NE 68959-1705 - Phone
- (308) 832-3400
- Fax
- (308) 832-3414
- NPI assigned
- Feb 8, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- KEARNEY CO HEALTH SERVICES
Authorized official
- Name
- Luke D Poore
- Title
- Ceo
- Phone
- (308) 832-3400
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 1
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 1
Practitioners 24
-
Jonathan Blecha, M.D.
-
Kaitlyn M Carlson, APRN
-
Cade Craig, M.D.
-
John A. E. Craig, M.D.
-
Sally Jean Farquhar, APRN
-
Diane Kae Jackson, A.P.R.N.
-
Shannon Dee Kuehn, APRN
-
Sara Ann Slingsby, APRN
-
Douglas P. Wulf, APRN
-
Michelle Craig, PA-C
-
Sarah Renee Guthard, PA-C, ATC
-
Jennifer Marie Leiting, APRN
-
Jodie L. Scheele, PA-C
-
Michelle Denise Schiel, APRN
-
Caleb W Schroeder, M.D.
-
Matthew P Rutman, MD
-
Jeffrey A. Schopp, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NE
Rural health clinic certification: CCN 283416
- Legal name
- KEARNEY CO HEALTH SERVICES
- Doing business as
- MINDEN MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Feb 23, 1995
- Last certification
- Mar 4, 2020
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 727 E 1St St
Minden, NE 68959-1705 - Related CCNs
- 281306
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Janell Shelton |
W-2 Managing Employee |
Aug 18, 2008 | |
| Operational/Managerial Control |
Aug 18, 2008 | ||
| Gavin D Blum |
Corporate Officer |
Dec 16, 2019 | |
| W-2 Managing Employee |
Dec 16, 2019 | ||
| Operational/Managerial Control |
Dec 16, 2019 | ||
| Andrew P Grollmes |
Corporate Director | Jan 7, 2025 | |
| Stephen W Olson |
Corporate Officer | Jan 26, 2022 | |
| Corporate Director | Jan 1, 2017 | ||
| Samuel L Stadler |
Corporate Director | Feb 12, 2018 | |
| Douglas J Althouse |
W-2 Managing Employee |
Jan 1, 2015 | |
| Operational/Managerial Control |
Jan 1, 2015 | ||
| Jeffrey Hanson |
Corporate Director | Jan 1, 2012 | |
| Luke D Poore |
Corporate Officer |
Apr 18, 2016 | |
| W-2 Managing Employee |
Apr 18, 2016 | ||
| Operational/Managerial Control |
Apr 18, 2016 | ||
| Aaron J Dahlgren |
Corporate Officer | Jan 25, 2023 | |
| Corporate Director | Apr 27, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040223001142 | NE | Part B Supplier - Clinic/Group Practice | 8820900780 |
Receives reassigned benefits from 24 practitioners 2 other NPIs on this enrollment Practice locations: Minden, NE |
| O20050114000094 | NE | Part a Provider - Rural Health Clinic | 8820900780 | Practice locations: Minden, NE |
National Provider Directory
- Part of
- Kearney County Comm Hospi
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/afb10dcd-fcfe-4394-bcee-f9c44a02df40/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
727 E 1St St
Minden, NE 68959-1705
Mailing address
727 E 1St St
Minden, NE 68959-1705
Phone (308) 832-3400
Other names
- Minden Medical Clinic
Other providers in Minden, NE
- Jody Ann Hudson
- Innovative Pharmacists Inc
- Chad Isaacson
- Diane Kae Jackson
- Obadiah Luke Johnson
- Kearney Co Health Services
- Kearney Co Health Services
- Kearney Co Health Services
- Amy Marie Kingston
- Dakota Nicholas Kingston
All providers in Minden, NE · Rural Health Clinic/Center in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.