West Holt Memorial Hospital
Organization Active NPI Critical Access Hospital · Atkinson, NE
NPI 1295785442 · NPPES record last updated Dec 17, 2021
Key facts
- NPI
- 1295785442
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 410001 (NE)
- Legal business name
- WEST HOLT MEMORIAL HOSPITAL
- Practice address
- 406 W Neely St
Atkinson, NE 68713-4801 - Phone
- (402) 925-2811
- Fax
- (402) 925-2810
- NPI assigned
- May 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeremy Bauer
- Title
- Cfo
- Phone
- (402) 925-1947
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Related certifications (CCN) 2
Practitioners 13
-
Steven H Carlsen, PA-C
-
Blake Cover, M.D.
-
April J Dexter, APRN/NP-C
-
Breanna Nicole Fiene, MSN, APRN, FNP-C
-
Amy Anne Rentschler, PA-C
-
Samantha Sholes, MD
-
Jeanne M Laible, PA
-
Amelia Shane McCumber, PA-C
-
John D Tubbs, M.D.
Affiliated clinicians 46
-
Bibek Adhikari, MD
-
Dean L Benson, MPAC
-
Kaitlin Gilham Brau, M.D.
-
Steven H Carlsen, PA-C
-
Blake Cover, M.D.
-
April J Dexter, APRN/NP-C
-
Sneha Dhakal, MD
-
Breanna Nicole Fiene, MSN, APRN, FNP-C
-
Sara K. Frederick, PA-C
-
Kari L Galyen, MD
-
Zackary Bryan Gangwer, D.P.M.
-
Mellissa R Glenn, NP
-
Leah Rae Haak Beck, PA-C, RD
-
Steven D Janssen, PA-C
-
Amy L Jorgensen, PA-C
-
Camille Ann Kantai, APRN
-
Jeanne M Laible, PA
Medicare Care Compare: Hospital
- Listed as
- West Holt Memorial Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Hospital certification: CCN 281343
- Legal name
- WEST HOLT MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 1, 2000
- Last certification
- Feb 12, 2026
- Beds
- 15
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 21, 1972 in NE
- Enrollment address
- 406 W Neely St
Atkinson, NE 68713-4801
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Peek |
Corporate Director | Jan 1, 2022 | |
| Marsha Thurlow |
Corporate Director | Jan 1, 2022 | |
| Trent Schaaf |
Corporate Director | Jan 1, 2022 | |
| Lori Olson |
Corporate Director | Jan 1, 2022 | |
| Jeremy Bauer |
Corporate Officer |
Dec 1, 2018 | 100% |
| W-2 Managing Employee |
Dec 1, 2018 | 100% | |
| Thomas Dvorak |
Corporate Director | Jan 1, 2022 | 100% |
| Brett Lieswald |
Corporate Director | Jan 1, 2022 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071129000005 | NE | Part a Provider - Critical Access Hospital | 2264419878 |
Receives reassigned benefits from 13 practitioners Practice locations: Atkinson, NE |
National Provider Directory
- Tax ID family
- West Holt Medical Clini
Locations
405 W Pearl St
Atkinson, NE 68713
Phone (402) 925-2631
405 W Pearl St
Ste 1
Atkinson, NE 68713
406 W Neely St
Atkinson, NE 68713
Phone (402) 925-2811
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/wstholt-d1685583
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 410001 | NE | Yes |
Addresses
Primary practice location
406 W Neely St
Atkinson, NE 68713-4801
Mailing address
406 W Neely St
Atkinson, NE 68713-4801
Phone (402) 925-2811
Other providers in Atkinson, NE
- The Evangelical Lutheran Good Samaritan Society
- The Evangelical Lutheran Good Samaritan Society
- Kimberly Thompson
- True Spine Chiropractic, LLC
- Carlie Wenner
- West Holt Memorial Hospital
- West Holt Memorial Hospital
- West Holt Memorial Hospital
- West Holt Memorial Hospital
- West Holt Public Schools
All providers in Atkinson, NE · Critical Access Hospital in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.