Active NPI
Ogallala Community Hospital
- Rural Health Clinic/Center
- Ogallala, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- OGALLALA COMMUNITY HOSPITAL
- Practice address
- 2601 N Spruce St Ste a
Ogallala, NE 69153-2465 - Phone
- (308) 284-4011
- Fax
- (308) 284-7212
- NPI assigned
- Nov 29, 2022
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy Gullingsrud
- Title
- Ceo
- Phone
- (602) 747-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
2601 N Spruce St Ste a
Ogallala, NE 69153-2465
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other names 1
- Banner Health Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171107002773 | NE | Part A Provider - Rural Health Clinic | 3072517523 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ogallala, NE |
Rural health clinic certification: CCN 288548
- Legal name
- OGALLALA COMMUNITY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Mar 13, 2018
- Last certification
- Mar 13, 2018
- Ownership / control type
- 2B
- Organization structure
- Other
- Enrollment address
- 2601 N Spruce St
Ste a
Ogallala, NE 69153-2465 - Related CCNs
- 281355
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Ogallala Community Hosp
- Part of
- M E Lee MD
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Medicare Defined Swing Bed Hospital Unit
- Ogallala, NE
- NPI 1003968710
-
- Critical Access Hospital
- Ogallala, NE
- NPI 1154705358
-
- Rural Health Clinic/Center
- Ogallala, NE
- NPI 1366962706
-
- Multi-Specialty Clinic/Center
- Ogallala, NE
- NPI 1902304702
Ownership & related parties
All disclosed owners & managing parties 24
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 |
|---|---|---|---|
| Julie Ann Alvarado-Dubek | Corporate Officer | Feb 1, 2022 | |
| Marjorie J Bessel | Corporate Officer | Jan 1, 2018 | |
| Jean Lance | Corporate Officer | Jun 30, 2022 | |
| Staci Dickerson | Corporate Officer | Jul 17, 2023 | |
| W-2 Managing Employee | Jul 17, 2023 | ||
| Carole Faig | Corporate Director | Mar 1, 2026 | |
| Paris Labruzzo | Corporate Director | Dec 7, 2022 | |
| W-2 Managing Employee | Dec 7, 2022 | ||
| Timothy Gullingsrud | Corporate Officer | Dec 2, 2019 | |
| W-2 Managing Employee | Dec 2, 2019 | ||
| Dean M Harrison | Corporate Director | Sep 1, 2023 | |
| Anne Mariucci | Corporate Director | Mar 1, 2015 | |
| Sujata Gosalia | Corporate Director | Sep 1, 2018 | |
| Brenda a Schaefer | Corporate Officer | Mar 6, 2014 | |
| Quentin P Smith | Corporate Director | Sep 1, 1999 | |
| Vicki Keiser | Corporate Director | Jun 1, 2017 | |
| Holly Gregory | Corporate Director | Jul 24, 2020 | |
| W-2 Managing Employee | Jul 24, 2020 | ||
| Sara Ward | Corporate Director | Sep 1, 2023 | |
| Michael L Butler | Corporate Director | Sep 1, 2025 | |
| Mary Schubert | Corporate Officer | Jan 1, 2024 | |
| Amy Perry | Corporate Officer | Nov 1, 2021 | |
| Rick Myers | Corporate Director | Sep 1, 2023 | |
| John F Koster | Corporate Director | Dec 11, 2015 | |
| Mark Wallace | Corporate Director | Sep 1, 2021 | |
| Christopher H Volk | Corporate Director | Sep 1, 1999 | |
| Michael Garnreiter | Corporate Director | Aug 1, 2012 | |
| Banner Health | 5% Or Greater Direct Ownership Interest | Jan 1, 2018 | 100% |
| Operational/Managerial Control | Jan 1, 2018 | 100% |
Owners & managing parties with NPI records 12
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- General Acute Care Hospital
- Casa Grande, AZ
- NPI 1003232976
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Critical Access Hospital
- Payson, AZ
- NPI 1063923340
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Rural Health Clinic/Center
- Payson, AZ
- NPI 1073223012
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Multi-Specialty Clinic/Center
- Susanville, CA
- NPI 1205267549
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Rural Health Clinic/Center
- Pine, AZ
- NPI 1245940287
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Radiology Clinic/Center
- Susanville, CA
- NPI 1427740570
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Durable Medical Equipment & Medical Supplies
- Casper, WY
- NPI 1528846912
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- General Acute Care Hospital
- Fort Collins, CO
- NPI 1659787554
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Medicare Defined Swing Bed Hospital Unit
- Payson, AZ
- NPI 1861077414
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- General Acute Care Hospital
- Chandler, AZ
- NPI 1972139004
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 24
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Ogallala, NE
- NPI 1104699784
-
- Physician Assistant
- MC Cook, NE
- NPI 1902299860
-
- Obstetrics & Gynecology Physician
- Beatrice, NE
- NPI 1205067667
-
- Family Nurse Practitioner
- Ogallala, NE
- NPI 1811505431
-
- Family Medicine Physician
- Lincoln, NE
- NPI 1437387180
-
- Anesthesiology Physician
- Kearney, NE
- NPI 1376651729
-
- Dermatology Physician
- North Platte, NE
- NPI 1558504803
-
- Medical Physician Assistant
- Ogallala, NE
- NPI 1790789667
-
- Physician Assistant
- Ogallala, NE
- NPI 1578194668
-
- Certified Registered Nurse Anesthetist
- Ogallala, NE
- NPI 1275923922
-
- Family Medicine Physician
- Torrington, WY
- NPI 1790891919
-
- Orthopaedic Surgery Physician
- Englewood, CO
- NPI 1700033917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669680000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776297600000",
"number": "1396455481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N CENTRAL AVE STE 160",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 N SPRUCE ST STE A",
"city": "OGALLALA",
"state": "NE",
"postal_code": "691532465",
"telephone_number": "308-284-4011",
"fax_number": "308-284-7212"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OGALLALA COMMUNITY HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2022-11-29",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A",
"authorized_official_last_name": "GULLINGSRUD",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "602-747-4000"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Banner Health Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ogallala, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.