Active NPI
Midwest Covenant Home, Inc.
- Skilled Nursing Facility
- Stromsburg, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 644002
- Legal business name
- MIDWEST COVENANT HOME, INC.
- Practice address
- 615 E 9TH St
Stromsburg, NE 68666-4053 - Phone
- (402) 764-2711
- Fax
- (402) 764-4352
- NPI assigned
- Jul 19, 2005
- 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
- Mr. Christopher M Young
- Title
- Administrator
- Phone
- (402) 764-2711
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 644002 | NE | Primary |
Addresses
Primary practice location
615 E 9TH St
Stromsburg, NE 68666-4053
Mailing address
615 E 9TH St
PO Box 367
Stromsburg, NE 68666-4053
Phone (402) 764-2711
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F249543 | Other | AETNA | |
| F249543 | Other | CIGNA | |
| 00526 | Other | BLUE CROSS BLUE SHIELD | |
| 0640750001 | Other | DMERC | |
| F249543 | Other | TEAMCARE | |
| F249543 | Other | MIDLANDS CHOICE |
Other names 1
- Midwest Covenant Home, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050110000461 | NE | Part A Provider - Skilled Nursing Facility | 3779531447 | Practice locations: Stromsburg, NE |
Skilled nursing facility certification: CCN 285062
- Legal name
- MIDWEST COVENANT HOME, INC.
- Doing business as
- MIDWEST COVENANT HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 20, 1983
- Last certification
- Mar 26, 2025
- Beds
- 51
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 615 E 9TH St
Stromsburg, NE 68666-4053 - Nursing home name
- MIDWEST COVENANT HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Midwest Covenant Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Sep 20, 1983
- Medicare certification status
- Active
- Certified beds
- 51
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
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 |
|---|---|---|---|
| Susan Cooksley | Corporate Director | May 25, 2023 | |
| Sheila Bjerrum | Corporate Director | May 30, 2020 | |
| Adp of the SNF | Jan 20, 2025 | ||
| Terry Borg | Corporate Director | May 29, 2025 | |
| Michelle Dubas | Corporate Director | Feb 27, 2025 | |
| Mary Pinley | Corporate Director | May 29, 2025 | |
| Richard Boroviak | Corporate Director | May 25, 2023 | |
| Tamara Hutsell | Corporate Officer | May 29, 2025 | |
| Corporate Director | May 25, 2023 | ||
| Phil Burke | Corporate Officer | May 30, 2024 | |
| Corporate Director | May 19, 2022 | ||
| Bonnie Schreiber | Corporate Director | May 25, 2023 | |
| Cheri Giannou | Corporate Officer | May 25, 2023 | |
| Corporate Director | May 19, 2022 | ||
| Timothy V. Teegerstrom | Corporate Director | Jan 13, 2025 | |
| Fawn Ienn | Operational/Managerial Control | Mar 18, 2024 | |
| David B Jameson | Operational/Managerial Control | Jun 1, 2021 | |
| Adp of the SNF | Feb 5, 2025 | ||
| Timothy McIvor | Corporate Officer | May 29, 2025 | |
| Corporate Director | May 19, 2022 |
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
- Stromsburg, NE
- NPI 1083616502
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Stromsburg, NE
- NPI 1083616502
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": "1121731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1460419200000",
"number": "1326047697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 E 9TH ST",
"address_2": "PO BOX 367",
"city": "STROMSBURG",
"state": "NE",
"postal_code": "686664053",
"telephone_number": "402-764-2711",
"fax_number": "402-764-4352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 E 9TH ST",
"city": "STROMSBURG",
"state": "NE",
"postal_code": "686664053",
"telephone_number": "402-764-2711",
"fax_number": "402-764-4352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWEST COVENANT HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-19",
"last_updated": "2016-04-12",
"status": "A",
"authorized_official_last_name": "YOUNG",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "402-764-2711",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NE",
"license": "644002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "F249543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "F249543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00526",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0640750001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEAMCARE",
"identifier": "F249543",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "F249543",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Midwest Covenant Home, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Stromsburg, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.