Ogallala Community Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

OGALLALA COMMUNITY HOSPITAL

Doing business as

Banner Health Clinic

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

Last updated

Apr 16, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Addresses

Other names 1

• Banner Health Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396455481. Details of each certification follow.

• CCN 288548 Rural health clinic · Active · Details

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

OtherNon-profit

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.

• Ogallala Community Hospital

  • Critical Access Hospital
  • Ogallala, NE
  • NPI 1710915467

  Parent provider

  Provider of Services

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Ogallala Community Hospital

  • Rural Health Clinic/Center
  • Ogallala, NE
  • NPI 1366962706

  O20171107002773

  Same enrollment

Tax ID family

Ogallala Community Hospital5 organizations share this tax ID, including this one

Part of

Custer Comm Hosp Rad

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Ogallala Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ogallala, NE
  • NPI 1003968710
  NPD tax ID
• Ogallala Community Hospital

  • Critical Access Hospital
  • Ogallala, NE
  • NPI 1154705358
  NPD tax ID
• Ogallala Community Hospital

  • Rural Health Clinic/Center
  • Ogallala, NE
  • NPI 1366962706
  NPD tax ID
• Ogallala Community Hospital

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1902304702
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  Member Of

  NPD member

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.

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Banner Health

  dba Banner Casa Grande Medical Center

  • General Acute Care Hospital
  • Casa Grande, AZ
  • NPI 1003232976

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Payson Medical Center - Banner Health Clinic Payson

  • Rural Health Clinic/Center
  • Payson, AZ
  • NPI 1073223012

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  • Multi-Specialty Clinic/Center
  • Susanville, CA
  • NPI 1205267549

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Payson Medical Center - Banner Health Clinic Pine

  • Rural Health Clinic/Center
  • Pine, AZ
  • NPI 1245940287

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  • Radiology Clinic/Center
  • Susanville, CA
  • NPI 1427740570

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  • Durable Medical Equipment & Medical Supplies
  • Casper, WY
  • NPI 1528846912

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Fort Collins Medical Center

  • General Acute Care Hospital
  • Fort Collins, CO
  • NPI 1659787554

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Payson Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Payson, AZ
  • NPI 1861077414

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Banner Health

  dba Banner Ocotillo Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1972139004

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Marjorie Bessel, MD

  • Internal Medicine Physician
  • Gilbert, AZ
  • NPI 1710002068

  Corporate Officer

  CMS ownership

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Camellia Rae Brown, FNP

  • Family Nurse Practitioner
  • Ogallala, NE
  • NPI 1104699784
  NPD
• Erica Leigh Ellicott, PA-C

  • Physician Assistant
  • McCook, NE
  • NPI 1902299860
  NPD
• Angela Kay Grone, M.D.

  • Obstetrics & Gynecology Physician
  • Beatrice, NE
  • NPI 1205067667
  NPD
• Amy Dawn Hoffman, APRN-NP

  • Family Nurse Practitioner
  • Ogallala, NE
  • NPI 1811505431
  NPD
• Jessica K Leibhart, D.O.

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437387180
  NPD
• Burt John McKeag, MD

  • Anesthesiology Physician
  • Kearney, NE
  • NPI 1376651729
  NPD
• Daniel Dean Mosel, M.D.

  • Dermatology Physician
  • North Platte, NE
  • NPI 1558504803
  NPD
• Monica Rachelle Patin, PA-C

  • Medical Physician Assistant
  • Ogallala, NE
  • NPI 1790789667
  NPD
• Mara Peters

  • Physician Assistant
  • Ogallala, NE
  • NPI 1578194668
  NPD
• Laura Adele Strauss, CRNA

  • Certified Registered Nurse Anesthetist
  • Ogallala, NE
  • NPI 1275923922
  NPD
• Millard Todd Berry, M.D.

  • Family Medicine Physician
  • Torrington, WY
  • NPI 1790891919
  NPD
• Ryan Matthew Carr, MD

  • Orthopaedic Surgery Physician
  • Englewood, CO
  • NPI 1700033917
  NPD

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"
        }
    ]
}

• Justin Nelms
• Megan L Nowak, RN
• Ogallala Community Hospital
• Ogallala Community Hospital
• Ogallala Community Hospital
• Ogallala Community Hospital
• Ogallala Community Hospital
• Ogallala Counseling Inc PC
• Ogallala Eyecare PC
• Ogallala Medical Group

• Rural Health Clinic/Center in Ogallala, NE
• Providers in Ogallala, NE by specialty
• Rural Health Clinic/Center in Nebraska

• 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.

Verify at the official NPI Registry.