NPIMap

Organization Active NPI

Johnson County Hospital

  • Critical Access Hospital
  • Tecumseh, NE
National Provider Identifier
1285624825
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
450001 Issued in NE
Legal business name
JOHNSON COUNTY HOSPITAL
Practice address
202 High Street
Tecumseh, NE 68450-2443
Phone
(402) 335-3361
Fax
(402) 335-6342
NPI assigned
Oct 25, 2005
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Mary Jane Kent
Title
Ceo
Phone
(402) 335-3361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 450001 NE Primary

Addresses

Primary practice location

202 High Street
Tecumseh, NE 68450-2443

Mailing address

PO Box 599
Tecumseh, NE 68450-0599
Phone (402) 335-3361

Other identifiers 1

IdentifierTypeStateIssuer
00056OtherNEBCBS OF NEBRASKA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JohnsonCountyHospital@jchosp.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000037 NE Part A Provider - Critical Access Hospital 4688583644 Receives reassigned benefits from 41 practitioners
Practice locations: Tecumseh, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285624825. Details of each certification follow.

Hospital certification: CCN 281350

Legal name
JOHNSON COUNTY HOSPITAL
Doing business as
JOHNSON COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2001
Last certification
Sep 11, 2023
Beds
18
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
202 High St
Tecumseh, NE 68450-2443

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

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Johnson County HospitalCCN 281350 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Johnson County Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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
Faith a Parde Individual Corporate DirectorBoard Member Nov 1, 2008
Randy L Baucke Individual Corporate Officer Dec 15, 2011
Corporate Director Apr 1, 1996
Mary Kent Individual Corporate Director Feb 20, 2019
W-2 Managing Employee Feb 1, 2018
Operational/Managerial Control Feb 20, 2019
Harold E Kettelhake Individual Corporate Director Mar 31, 2000

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Johnson County Hospital Home Health ServicesTecumseh, NE, CCN 287073 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1980

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 43

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 43

Affiliated clinicians 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1285624825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "684500599",
            "telephone_number": "402-335-3361",
            "fax_number": "402-335-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HIGH STREET",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "684502443",
            "telephone_number": "402-335-3361",
            "fax_number": "402-335-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-335-3361"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "450001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "00056",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JohnsonCountyHospital@jchosp.cernerdirect.com",
            "affiliation": "N",
            "address_1": "202 High Street",
            "city": "Tecumseh",
            "state": "NE",
            "country_code": "US",
            "postal_code": "684502443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tecumseh, NE

Sources for this page

Verify at the official NPI Registry.