Active NPI
City of Stanton Nursing Home
Doing business as Stanton Health Center
- Skilled Nursing Facility
- Stanton, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 754001
- Legal business name
- CITY OF STANTON NURSING HOME
- Doing business as
- Stanton Health Center
- Practice address
- 301 17TH St
Stanton, NE 68779-0407 - Phone
- (402) 439-2111
- Fax
- (402) 439-2132
- NPI assigned
- Jul 11, 2006
- Last updated
- May 23, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Beth A Petersen
- Title
- Accounts Receivable
- Phone
- (402) 439-2111
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | NU | ||
| Assisted Living Facility | 310400000X | ALF193 | NE | |
| Skilled Nursing Facility | 314000000X | NU | ||
| Skilled Nursing Facility | 314000000X | 754001 | NE | Primary |
Addresses
Primary practice location
301 17TH St
Stanton, NE 68779-0407
Mailing address
PO Box 407
Stanton, NE 68779-0407
Phone (402) 439-2111
Other names 1
- Stanton Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081014000592 | NE | Part A Provider - Skilled Nursing Facility | 6103994488 | Practice locations: Stanton, NE |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1295760361. Details of each certification follow.
Skilled nursing facility certification: CCN 285102
- Legal name
- CITY OF STANTON NURSING HOME
- Doing business as
- STANTON HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 5, 1990
- Last certification
- Jun 13, 2024
- Beds
- 70
- Ownership / control type
- Church Related
- Organization structure
- Government
- Enrollment address
- 301 17TH St
Stanton, NE 68779-0407 - Nursing home name
- STANTON HEALTH CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Stanton Health Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Oct 5, 1990
- Medicare certification status
- Active
- Certified beds
- 70
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D0455686 | Stanton Health Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Amy Pohlman | Corporate Officer | Jan 1, 2014 | 20% |
| Managing Control - Governing Body | Jan 1, 2014 | ||
| Kyle Voecks | Corporate Officer | Jan 1, 2015 | 100% |
| Managing Control - Governing Body | Jan 1, 2015 | ||
| Kathy L Moore | Corporate Director | Oct 1, 2018 | 20% |
| Managing Control - Governing Body | Oct 1, 2018 | ||
| City of Stanton Nursing Home | 5% Or Greater Direct Ownership Interest | Mar 31, 1968 | 100% |
| Adp of the SNF | Mar 31, 1968 | ||
| Direct Ownership Interest | Mar 31, 1968 | 100% | |
| Rae K Caskey | Corporate Officer | Jan 1, 2023 | 20% |
| Managing Control - Governing Body | Jan 1, 2023 | ||
| Bryon D Hirschman | Adp of the SNF | Jan 1, 2015 | |
| Indirect Ownership Interest | Jan 1, 2015 | 1% | |
| Colleen M Paden | Corporate Officer | Jan 1, 2017 | 20% |
| Managing Control - Governing Body | Jan 1, 2017 | ||
| Pat a Larson | Corporate Officer | Jan 1, 2018 | 20% |
| Managing Control - Governing Body | Jan 1, 2018 | ||
| Sonya R. Lammli Locke | Operational/Managerial Control | Jul 3, 2022 | |
| Indirect Ownership Interest | Jul 3, 2022 | 1% | |
| Jonathan R Brandow | Corporate Director | Jul 1, 2023 | 100% |
| Adp of the SNF | Jul 1, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Norfolk, NE
- NPI 1194739912
Adp of the SNF, Indirect Ownership Interest
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Medicine Physician
- Norfolk, NE
- NPI 1194739912
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Psychiatric/Mental Health Nurse Practitioner
- Norfolk, NE
- NPI 1558617381
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653264000000",
"number": "1295760361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 407",
"city": "STANTON",
"state": "NE",
"postal_code": "687790407",
"telephone_number": "402-439-2111",
"fax_number": "402-439-2132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 17TH ST",
"city": "STANTON",
"state": "NE",
"postal_code": "687790407",
"telephone_number": "402-439-2111",
"fax_number": "402-439-2132"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF STANTON NURSING HOME",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-11",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A",
"authorized_official_last_name": "PETERSEN",
"authorized_official_first_name": "BETH",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "ACCOUNTS RECEIVABLE",
"authorized_official_telephone_number": "402-439-2111"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NE",
"license": "ALF193",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NE",
"license": "754001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Stanton Health Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Stanton Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Stanton, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.