Coffey County Hospital
Organization Active NPI Critical Access Hospital · Burlington, KS
NPI 1376548370 · NPPES record last updated Jan 15, 2019
Key facts
- NPI
- 1376548370
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- COFFEY COUNTY HOSPITAL
- Practice address
- 801 N 4TH
Burlington, KS 66839-2602 - Phone
- (620) 364-2121
- Fax
- (620) 364-4525
- NPI assigned
- Jun 16, 2005
- Organization subpart
- No
Authorized official
- Name
- Merri Michaels
- Title
- Billing Mananger
- Phone
- (620) 364-2121
Owners & managing parties with NPI records 8
-
John R Shell, M.D.
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 6
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 36
-
Ashley Renee Beying, APRN
-
Donald N Braun, M.D.
-
Mark Alan Greenfield, M.D.
-
Christopher D Jarvis, M.D.
-
Sonya Jurgens, CRNA
-
Laurel Louderbaugh, RN, MN, ARNP-C
-
Myra Anne Richard, DNP, APRN-C
-
John R Shell, M.D.
-
Jon O Sides, M.D.
-
Jeff M Sloyer, M.D.
-
Erica Corrine Hadley, C.R.N.A.
-
Todd A Brown, M.D.
-
Teresa N Camfield, APRN
-
Joseph P Clark, PA
-
Aric Brendan Deyoung, CRNA
-
Deedra Frederick, APRN
-
Heather Lynnette Frisbie, C.R.N.A.
-
Nicholas Adam Isakson, CRNA
-
Jason Edward Kimm, FNP
-
Dyllan Landry, MD
-
Norma Kathryn Linde, APRN
Affiliated clinicians 90
-
Bahaa Abu Bakr, MD
-
Kamran M Ali, MD
-
Sindhu Reddy Avula, M.D
-
Christopher G Baalmann, M.D.
-
Angela T Bachelor, A.R.N.P.
-
Ashley Renee Beying, APRN
-
Partha Bhurtel, MD
-
Hemant Boolani, M.D.
-
Kelli L Bradbury, APRN
-
Donald N Braun, M.D.
-
Todd A Brown, M.D.
-
Shekhar K Challa, MD
-
Sumer K Dhir, M.D.
-
Nathan Dobbs, MD
-
Shane T. Fejfar, M.D.
Medicare Care Compare: Hospital
- Listed as
- Coffey County Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Hospital certification: CCN 171385
- Legal name
- COFFEY COUNTY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jul 11, 2017
- Last certification
- Jul 11, 2017
- Beds
- 25
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Incorporated
- in KS
- Enrollment address
- 801 N 4TH St
Burlington, KS 66839-2602
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Allegre |
Corporate Director |
Jan 1, 2013 | |
| Perry Dale Chapman |
Corporate Director |
Dec 19, 2022 | |
| Stacy Nicole Augustyn |
Corporate Officer |
Jul 1, 2022 | |
| W-2 Managing Employee | Jul 1, 2022 | ||
| Jodi Lynn Thomas |
Corporate Director |
Jan 1, 2017 | |
| Michael Paul Abendroth |
Corporate Director |
Dec 27, 2023 | |
| Coffey County Hospital |
Operational/Managerial Control | Jan 1, 1966 | 100% |
| Stephen Craig Hopkins |
Corporate Director | Jan 1, 2014 | |
| Craig Howard Stukey |
Corporate Officer |
Sep 4, 2018 | |
| W-2 Managing Employee |
Sep 4, 2018 | ||
| Eric Russell Ervin |
Corporate Director | Jan 2, 2024 | |
| Jeff Blair Clark |
Corporate Director |
Jan 1, 2016 | |
| County of Coffey |
5% Or Greater Direct Ownership Interest | Jan 1, 1966 | 100% |
| John R Shell |
Corporate Officer |
Aug 1, 1993 | |
| W-2 Managing Employee |
Jan 1, 2017 | 100% | |
| Robert Melvin Fleming |
Corporate Director |
Jan 2, 2024 | |
| Arden Wayne Payer |
Corporate Director |
Jan 2, 2024 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Coffey County Hospital |
Hospital | Other (100%) | Jan 1, 2017 |
| Coffey County Medical Center RHC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (75%) | Jan 1, 1966 |
| Waverly Medical Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Apr 16, 1991 |
| Yates Center Medical Center Rural Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jul 18, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170317000027 | KS | Part a Provider - Critical Access Hospital | 4981598653 |
Receives reassigned benefits from 34 practitioners Practice locations: Burlington, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | KS | ||
| Critical Access Hospital | 282NC0060X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X | KS |
Addresses
Primary practice location
801 N 4TH
Burlington, KS 66839-2602
Mailing address
801 N 4TH St
Burlington, KS 66839-2602
Phone (620) 364-2121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100098820A | Medicaid | KS | |
| 180038 | Other | KS | BLUE CROSS BLUE SHEILD |
Other names
- Coffey County Hospital
Other providers in Burlington, KS
- Burlington Usd 244 Coffey County Special Education Cooperative
- Megan Rae Bush
- Joseph P Clark
- Coffey County Hospital
- Coffey County Hospital
- Coffey County Hospital
- Coffey County Hospital
- Coffey County Hospital
- Coffey County Hospital
- Coffey County Hospital
All providers in Burlington, KS · Critical Access Hospital in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 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.