Wichita County Health Center
Organization
Active NPI
Medicare Defined Swing Bed Hospital Unit · Leoti, KS
NPI 1316937428 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1316937428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- H102001
- Legal business name
- WICHITA COUNTY HEALTH CENTER
- Practice address
- 211 East Earl
Leoti, KS 67861-9802
- Phone
- (620) 375-2233
- Fax
- (620) 375-2646
- NPI assigned
- Oct 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Amanda Baker
- Title
- Cfo
- Phone
- (620) 375-2233
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Corporate family (same tax ID) 3
Organizations that report the same tax identification number in the National Provider Directory.
Facilities connected through Provider of Services related, parent or unit certification numbers.
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Hospital certification: CCN 17Z306
- Legal name
- WICHITA COUNTY HEALTH CENTER
- Organization structure
- Other · Non-profit
- Enrollment address
- 211 E Earl
Leoti, KS 67861-9620
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.
| Name | Role | Since | Share |
|---|
Teresa S Clark
Individual
|
Corporate Director
Ceo |
Sep 16, 2015 |
100% |
| W-2 Managing Employee |
Sep 16, 2015 |
100% |
Wichita County Health Center
Organization · Leoti, KS
|
Operational/Managerial Control |
Sep 16, 2015 |
100% |
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| O20070226000687 |
KS |
Part a Provider - Critical Access Hospital |
7113837535 |
Practice locations: Leoti, KS |
National Provider Directory
- Tax ID family
- Wichita City HLTH (4 organizations share this tax ID)
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Medicare Defined Swing Bed Hospital Unit |
275N00000X |
H102001 |
|
Yes |
Addresses
Primary practice location
211 East Earl
Leoti, KS 67861-9802
Mailing address
211 East Earl
Leoti, KS 67861-9504
Phone (620) 375-2233
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 001620 | Other | KS | BCBS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| Direct Messaging Address |
WichitaCo.Hospital@WichitaCounty-GPHA.cernerdirect.com |
Direct |
|
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.
Verify at the official NPI Registry.