NPIMap

Organization Active NPI

Brown County Hospital

Doing business as BCH Professional Services

  • Emergency Medicine Physician
  • Ainsworth, NE
National Provider Identifier
1417027210
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BROWN COUNTY HOSPITAL
Doing business as
BCH Professional Services
Practice address
945 E Zero St
Ainsworth, NE 69210-1556
Phone
(402) 387-2800
Fax
(402) 387-2804
NPI assigned
Nov 9, 2006
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BROWN COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Mirya Hallock
Title
Ceo
Phone
(402) 387-2800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Emergency Medicine Physician 207P00000X NU Primary
Otolaryngology Physician 207Y00000X NU
Podiatrist 213E00000X NU

Addresses

Primary practice location

945 E Zero St
Ainsworth, NE 69210-1556

Mailing address

945 E Zero St
Ainsworth, NE 69210-1556
Phone (402) 387-2800

Other names 1

  • BCH Professional Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051007000313 NE Part B Supplier - Clinic/Group Practice 4789593831 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Ainsworth, NE

Other NPIs with the same Medicare PAC ID 3

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

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
Part of
Brown County Clinic

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Brown County HospitalAinsworth, NE, CCN 281325 Hospital Operational/Managerial Control May 1, 2000
Brown County HospitalAinsworth, NE, CCN 28Z325 Hospital Operational/Managerial Control May 1, 2000
Ainsworth Family ClinicAinsworth, NE, CCN 288520 Rural health clinic Operational/Managerial Control Jun 1, 2013

Owned or controlled facilities with NPI records 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1417027210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 E ZERO ST",
            "city": "AINSWORTH",
            "state": "NE",
            "postal_code": "692101556",
            "telephone_number": "402-387-2800",
            "fax_number": "402-387-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E ZERO ST",
            "city": "AINSWORTH",
            "state": "NE",
            "postal_code": "692101556",
            "telephone_number": "402-387-2800",
            "fax_number": "402-387-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROWN COUNTY HOSPITAL",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "HALLOCK",
        "authorized_official_first_name": "MIRYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-387-2800"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ainsworth, NE

Sources for this page

Verify at the official NPI Registry.