NPIMap

Organization Active NPI

Gove County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Quinter, KS
National Provider Identifier
1295771608
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
GOVE COUNTY MEDICAL CENTER
Practice address
520 W 5TH Street
Quinter, KS 67752-0129
Phone
(785) 754-3341
Fax
(785) 754-3329
NPI assigned
Jun 22, 2006
Last updated
Jul 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Mr. Richard Q Bergling
Title
Ceo
Phone
(785) 754-3341

Specialties & licenses 1

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

Addresses

Primary practice location

520 W 5TH Street
Quinter, KS 67752-0129

Mailing address

PO Box 129
520 W 5TH Street
Quinter, KS 67752-0129
Phone (785) 754-3341

Other identifiers 1

IdentifierTypeStateIssuer
001637OtherKSBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070219000365 KS Part A Provider - Critical Access Hospital 5799672499 Practice locations: Quinter, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295771608. Details of each certification follow.

Hospital certification: CCN 17Z367

Legal name
GOVE COUNTY MEDICAL CENTER
Doing business as
GOVE COUNTY MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
520 W 5TH St
Quinter, KS 67752-9705
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Gove County Med Ctr4 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 2

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

NameRoleSinceShare
Conner Fiscarelli Individual Corporate Officer Aug 27, 2021
W-2 Managing Employee Aug 24, 2021
Gove County Medical Center Organization, Quinter, KS Operational/Managerial Control Jan 1, 2015 100%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1295771608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "address_2": "520 W 5TH STREET",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677520129",
            "telephone_number": "785-754-3341",
            "fax_number": "785-754-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 5TH STREET",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677520129",
            "telephone_number": "785-754-3341",
            "fax_number": "785-754-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOVE COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "BERGLING",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-754-3341",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001637",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quinter, KS

Sources for this page

Verify at the official NPI Registry.