The Clara Barton Hospital Association Inc Hoisington Kansas
Organization Active NPI Surgery Physician · Great Bend, KS
NPI 1366700593 · NPPES record last updated Aug 2, 2019
Key facts
- NPI
- 1366700593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- H-005-003 (KS)
- Legal business name
- THE CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS
- Practice address
- 1031 Jackson St
Great Bend, KS 67530-4219 - Phone
- (620) 793-6990
- NPI assigned
- Apr 25, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. James G Blackwell
- Title
- President & Ceo
- Phone
- (620) 653-2114
Owners & managing parties with NPI records 6
Other NPIs on the same Medicare enrollment 7
Related certifications (CCN) 4
Practitioners 2
-
Kelci J Burkey, PA-C
-
Linda K Krug, PA-C
Affiliated clinicians 117
-
Richard G Allenbach, PA-C
-
Leah A Alpers, PA-C
-
Sawsan Amireh, MD
-
Jenna Kay Anderson, PA-C
-
Wade Babcock, PAC
-
Daren L. Badura, MPA
-
Laura E Ballard, APRN
-
Phillip D Barnes, PA
-
Ken H Baxa, DO
-
Kimberly Beary, LSCSW
-
Angela Crystal Beck, NP-C
-
Elizabeth A Berger, PA-C
-
Taylor J Bieberle, PA-C
-
Joshua Johnson Boone, DPM
-
Amy L Bornholdt, PA
-
Ashley Y Boxberger, PA-C
-
Debra S Brockel, PA
-
Lindsey Gleed Broin, APRN
-
Elisa Jeannette Brown, APRN
-
Kelci J Burkey, PA-C
-
Bassem Mounir Chehab, M.D.
Medicare Care Compare: Hospital
- Listed as
- Clara Barton Hospital
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Hospital certification: CCN 171333
- Legal name
- THE CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS
- Doing business as
- CLARA BARTON HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Mar 29, 2001
- Last certification
- May 26, 2016
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 14, 1946 in KS
- Enrollment address
- 250 W 9TH St
Hoisington, KS 67544-1706
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Anthony Harmon |
Corporate Director |
Jan 1, 2023 | 10% |
| Kathleen Burt |
Corporate Director |
Mar 1, 2021 | 10% |
| Eric Jay Schoendaler |
Corporate Director |
Jan 1, 2023 | 10% |
| Gary Shook |
Corporate Director |
Feb 1, 2019 | 10% |
| Kathleen Renee Kaiser |
Corporate Director |
Jan 25, 2016 | 10% |
| Karisa Jo Cowan |
Corporate Director |
Sep 1, 2021 | 10% |
| Timothy S Webb |
Corporate Officer |
Mar 1, 2024 | 10% |
| The Clara Barton Hospital Association Inc Hoisington Kansas |
Operational/Managerial Control | Jun 16, 1997 | 100% |
| Lois a. McLeland |
Corporate Director |
Sep 1, 2021 | 10% |
| Amanda Hoffman |
Corporate Officer |
Sep 1, 2020 | |
| W-2 Managing Employee |
Jun 1, 2017 | ||
| James D Tusten |
Corporate Officer |
Aug 21, 2023 | 10% |
| W-2 Managing Employee |
Aug 21, 2023 | 100% | |
| Melissa B. Nech |
Corporate Director |
Feb 1, 2019 | 10% |
| Mary Bennett |
W-2 Managing Employee |
Feb 18, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040120001002 | KS | Part B Supplier - Clinic/Group Practice | 6709798622 |
Receives reassigned benefits from 54 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Great Bend, KS; Hoisington, KS; Larned, KS; Russell, KS |
| O20061104000200 | KS | Part a Provider - Critical Access Hospital | 6709798622 |
Receives reassigned benefits from 20 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hoisington, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | H-005-003 | KS | Yes |
Addresses
Primary practice location
1031 Jackson St
Great Bend, KS 67530-4219
Mailing address
250 W 9TH St
Hoisington, KS 67544-1706
Phone (620) 653-2114
Other names
- Clara Barton Surgical Services-GB
Other providers in Great Bend, KS
- Kim Hunter Taylor
- Kristin Teel
- The Center for Counseling
- The Center for Counseling
- The Center for Counseling and Consultation
- The Clara Barton Hospital Association, Inc. Hoisington Kansas
- The University of Kansas Health System Home Health - Great Bend, LLC
- The University of Kansas Health System Hospice - Great Bend, LLC
- Brik Darron Thompson
- Jake Colton Thompson
All providers in Great Bend, KS · Surgery Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2019. 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.