NPIMap

Organization Active NPI

Cozad Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Cozad, NE
National Provider Identifier
1285677633
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
220001 Issued in NE
Legal business name
COZAD COMMUNITY HOSPITAL
Practice address
300 E 12TH St
Cozad, NE 69130-1532
Phone
(308) 784-2261
Fax
(308) 784-4691
NPI assigned
Jun 14, 2006
Last updated
Jul 8, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COZAD COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Robert J Dyer
Title
Ceo
Phone
(308) 784-2261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 220001 NE Primary

Addresses

Primary practice location

300 E 12TH St
Cozad, NE 69130-1532

Mailing address

PO Box 108
Cozad, NE 69130-0108
Phone (308) 784-2261

Other identifiers 1

IdentifierTypeStateIssuer
00280OtherNEBCBS OF NE PROV #

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050303001046 NE Part B Supplier - Clinic/Group Practice 6507810389 Receives reassigned benefits from 16 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cozad, NE
O20071108000136 NE Part A Provider - Critical Access Hospital 6507810389 Practice locations: Cozad, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285677633. Details of each certification follow.

Hospital certification: CCN 28Z327

Legal name
COZAD COMMUNITY HOSPITAL
Doing business as
COZAD COMMUNITY HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
300 E 12TH St
Cozad, NE 69130-1532
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Cozad Community Hospital

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Robert J Dyer Individual Corporate OfficerCeo Feb 8, 2022
W-2 Managing EmployeeCeo Feb 8, 2022
Operational/Managerial ControlCeo Feb 8, 2022
Matthew D Burkholder Individual Corporate Officer May 23, 2006
Corporate Director Feb 28, 2006
Cynthia M Finnegan Individual Corporate Director May 22, 2018
Alan J Svajgr Individual Corporate Director May 25, 2010
Linda R Benjamin Individual Corporate Officer Jun 24, 2014
Corporate Director Dec 17, 2013
Patrick G Wetovick Individual W-2 Managing EmployeeChief Medical Officer Apr 28, 2022
Operational/Managerial ControlChief Medical Officer Apr 28, 2022
Bill C Wilkinson Individual Corporate Officer Jun 23, 2022
Corporate Director May 22, 2018
Lisa M Hunke Individual W-2 Managing EmployeeCfo May 1, 2001
Operational/Managerial ControlCfo May 1, 2001

Owners & managing parties with NPI records 1

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

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1285677633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "COZAD",
            "state": "NE",
            "postal_code": "691300108",
            "telephone_number": "308-784-2261",
            "fax_number": "308-784-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 12TH ST",
            "city": "COZAD",
            "state": "NE",
            "postal_code": "691301532",
            "telephone_number": "308-784-2261",
            "fax_number": "308-784-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COZAD COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COZAD COMMUNITY HOSPITAL",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-784-2261"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "220001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE PROV #",
            "identifier": "00280",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cozad, NE

Sources for this page

Verify at the official NPI Registry.