NPIMap

Organization Active NPI

Memorial Community Hospital Corporation

  • Critical Access Hospital
  • Blair, NE
National Provider Identifier
1265408819
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
790001 Issued in NE
Legal business name
MEMORIAL COMMUNITY HOSPITAL CORPORATION
Practice address
810 N 22ND St
Blair, NE 68008-1128
Phone
(402) 426-2182
Fax
(406) 426-1181
NPI assigned
Feb 24, 2006
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL COMMUNITY HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Amy Zimmer
Title
Cne/VP Patient Care Services
Phone
(402) 426-2182

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X
Critical Access Hospital 282NC0060X 790001 NE Primary

Addresses

Primary practice location

810 N 22ND St
Blair, NE 68008-1128

Mailing address

PO Box 250
Blair, NE 68008-1128
Phone (402) 426-2182

Other identifiers 1

IdentifierTypeStateIssuer
00088OtherNEBLUE CROSS

Other names 1

  • MCH&Health System/Blair Clinic/Cottonwood Clinic/Fort C Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040202001065 NE Part B Supplier - Clinic/Group Practice 0749190775 Receives reassigned benefits from 84 practitioners
3 other NPIs on this enrollment
Practice locations: Tekamah, NE; Fort Calhoun, NE; Blair, NE
O20071128000030 NE Part A Provider - Critical Access Hospital 0749190775 Receives reassigned benefits from 66 practitioners
Practice locations: Blair, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265408819. Details of each certification follow.

Hospital certification: CCN 281359

Legal name
MEMORIAL COMMUNITY HOSPITAL CORPORATION
Doing business as
MEMORIAL COMMUNITY HOSPITAL HEALTH SYSTEMS
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2003
Last certification
Apr 10, 2025
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Nov 21, 1956 in NE
Enrollment address
810 N 22ND St
Blair, NE 68008-1128
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Community Hospital & Health SystemCCN 281359 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Memorial Comm Hosp

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3519 Highway 32
Tekamah, NE 68061
Phone (402) 374-1585

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Memorial Community Hospital Corporation Organization, Blair, NE Corporation, Non-profit Operational/Managerial Control Apr 1, 2002 60%
Alegent Creighton Health Organization, Omaha, NE Non-profit Other Apr 1, 2002
Manuela Wolf Individual Contracted Managing EmployeePresident/Ceo Mar 1, 2018
Operational/Managerial ControlPresident/Ceo Mar 1, 2018
Amy Zimmer Individual Corporate OfficerCne/VP of Patient Services Dec 7, 2020
Corporate DirectorCne/VP of Patient Services Dec 7, 2020
W-2 Managing EmployeeCne/VP of Patient Services Dec 7, 2020
Operational/Managerial ControlCne/VP of Patient Services Dec 7, 2020
Evert Kuiper Individual OtherCHI Ceo Jan 1, 2022
Alegent Health Immanuel Medical Center Organization, Omaha, NE Non-profit Operational/Managerial Control Apr 2, 2002 40%
Melissa Templar Individual W-2 Managing EmployeeMedical Staff Services Lead Aug 15, 2011

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Memorial Community Hospital & Health SystemBlair, NE, CCN 28Z359 Hospital Operational/Managerial Control (60%) Apr 1, 2002
MCH Physicians; Blair ClinicBlair, NE, CCN 283462 Rural health clinic Operational/Managerial Control (60%) Apr 1, 2002
Cottonwood Rural Health ClinicTekamah, NE, CCN 283404 Rural health clinic Operational/Managerial Control (60%) Apr 1, 2002
Fort Calhoun ClinicFort Calhoun, NE, CCN 288506 Rural health clinic Operational/Managerial Control (60%) Apr 1, 2002

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 89

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.

View all 89

Affiliated clinicians 103

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

View all 103

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1265408819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-2182",
            "fax_number": "402-426-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-2182",
            "fax_number": "406-426-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL COMMUNITY HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL COMMUNITY HOSPITAL CORPORATION",
        "enumeration_date": "2006-02-24",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CNE/VP PATIENT CARE SERVICES",
        "authorized_official_telephone_number": "402-426-2182"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "790001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00088",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH&Health System/Blair Clinic/Cottonwood Clinic/Fort C",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MCH&Health System/Blair Clinic/Cottonwood Clinic/Fort C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blair, NE

Sources for this page

Verify at the official NPI Registry.