NPIMap

Organization Active NPI

Pratt Regional Medical Center Corporation

  • Medicare Defined Swing Bed Hospital Unit
  • Pratt, KS
National Provider Identifier
1407909963
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
PRATT REGIONAL MEDICAL CENTER CORPORATION
Practice address
200 Commodore St
Pratt, KS 67124-2903
Phone
(620) 672-7451
NPI assigned
Jan 19, 2007
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tammy Smith
Title
Ceo
Phone
(620) 672-7451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

200 Commodore St
Pratt, KS 67124-2903

Mailing address

200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-7451

Other names 1

  • Swing Unit Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070223000568 KS Part A Provider - Hospital 1355253238 Practice locations: Pratt, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407909963. Details of each certification follow.

Hospital certification: CCN 17U027

Legal name
PRATT REGIONAL MEDICAL CENTER CORPORATION
Doing business as
PRATT REGIONAL MEDICAL CENTER
Organization structure
CorporationProprietary
Enrollment address
200 Commodore St
Pratt, KS 67124-2903
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pratt Regional Med CNTR5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Pratt Regional Medical Center Corporation Organization, Pratt, KS Corporation, Non-profit Operational/Managerial Control Jul 1, 2015
Tammy Smith Individual Corporate DirectorCeo Jul 15, 2022 50%
W-2 Managing EmployeeCeo Jul 15, 2022 50%
Gary D Barker Individual Corporate DirectorBoard Member Jul 19, 2004
Suzanne Moore Individual Corporate DirectorBoard Member Jan 1, 2021
Scott W Gordon Individual Corporate DirectorBoard Member Jan 1, 2022
Josh Nicolay Individual Corporate DirectorBoard Member Apr 1, 2023
William K Keller Individual Corporate DirectorChairman Jul 19, 2004
John W Fowler Individual Corporate DirectorBoard Member Aug 13, 2009
Nicole Griffith Individual Corporate OfficerController Aug 1, 2021
W-2 Managing EmployeeController Aug 1, 2021
Shelly Little Individual Corporate DirectorBoard Member Jun 24, 2024
Jeanette M Siemens Individual Corporate DirectorBoard Member Jul 19, 2004
Tonya Powell Individual Corporate OfficerInterim Cfo Nov 22, 2024
Corporate DirectorInterim Cfo Nov 22, 2024
Luis E Espinoza Individual Corporate DirectorChief of Staff Jan 1, 2024
Dakota Holtgrieve Individual Corporate DirectorBoard Member Jan 1, 2021
Becca Flowers Individual Corporate DirectorVice Chairman Jan 17, 2011

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pratt Regional Medical Center Home Health AgencyPratt, KS, CCN 178000 Home health agency Operational/Managerial Control Oct 22, 2014
Pratt Internal Medicine GroupPratt, KS, CCN 178583 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1407909963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT REGIONAL MEDICAL CENTER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-672-7451"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swing Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pratt, KS

Sources for this page

Verify at the official NPI Registry.