NPIMap

Organization Active NPI

Sheridan County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Hoxie, KS
National Provider Identifier
1245334440
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H090001 Issued in KS
Legal business name
SHERIDAN COUNTY HOSPITAL
Practice address
826 18TH Street
Hoxie, KS 67740-0167
Phone
(785) 675-3281
Fax
(785) 675-3840
NPI assigned
Sep 11, 2006
Last updated
Feb 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Authorized official

Name
Jackie Rose
Title
Office Manager
Phone
(785) 675-3281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H090001 KS Primary

Addresses

Primary practice location

826 18TH Street
Hoxie, KS 67740-0167

Mailing address

826 18TH St
PO Box 167
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
O20070226000768 KS Part A Provider - Critical Access Hospital 7416842380 Practice locations: Hoxie, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245334440. Details of each certification follow.

Hospital certification: CCN 17Z347

Legal name
SHERIDAN COUNTY HOSPITAL
Doing business as
SHERIDAN COUNTY HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
826 18TH St
Hoxie, KS 67740-0167
Hospital Swing-Bed Unit

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).

National Provider Directory

National Provider Directory
Tax ID family
Hoxie Dental 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.

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
Chad Koster Individual Corporate OfficerCeo Apr 4, 2022
W-2 Managing EmployeeCeo Apr 4, 2022
Kenneth Eland Individual Corporate OfficerHospital Board Member Apr 1, 2013
Michael Mullins Individual Corporate OfficerHospital Board Member Apr 1, 2013
Joy Bretz Individual Corporate OfficerHospital Board Member Apr 7, 2015
Lucille Heim Individual Corporate OfficerHospital Board Member Apr 1, 2014
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

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1245334440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 18TH ST",
            "address_2": "PO BOX 167",
            "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 STREET",
            "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": "2006-09-11",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "785-675-3281"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H090001",
            "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.