NPIMap

Organization Active NPI

Jefferson Community Health Center, Inc

  • Skilled Nursing Facility
  • Fairbury, NE
National Provider Identifier
1417198367
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
LTCH010 Issued in NE
Legal business name
JEFFERSON COMMUNITY HEALTH CENTER, INC
Practice address
2200 H St
Fairbury, NE 68352-1119
Phone
(402) 729-3351
Fax
(402) 729-2102
NPI assigned
Mar 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Authorized official

Name
Chad E Jurgens
Title
Cfo
Phone
(402) 729-3351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X LTCH010 NE Primary

Addresses

Primary practice location

2200 H St
Fairbury, NE 68352-1119

Mailing address

2200 H St
Fairbury, NE 68352-1119
Phone (402) 729-3351

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090506000206 NE Part A Provider - Skilled Nursing Facility 2668574542 Practice locations: Fairbury, NE

Skilled nursing facility certification: CCN 285282

Legal name
JEFFERSON COMMUNITY HEALTH CENTER INC
Doing business as
JEFFERSON COMMUNITY HEALTH & LIFE GARDENSIDE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2009
Last certification
Nov 13, 2024
Beds
40 (39 certified)
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Enrollment address
2200 H St
Box 277
Fairbury, NE 68352-0277
Nursing home name
JEFFERSON COMMUNITY HEALTH & LIFE GARDENSIDE

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jefferson Community Health & Life GardensideCCN 285282
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 1, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3930.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Co Mem Hosp Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Rebecca a Stroklund Individual Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Justin Fulton Individual Corporate Director Jan 16, 2025
Carolyn M Scherbarth Individual Corporate Director Jan 20, 2022
Jefferson Community Health Center Inc Organization, Fairbury, NE Corporation, Medical provider/supplier 5% Or Greater Direct Ownership Interest Sep 25, 2009 100%
Operational/Managerial Control Dec 26, 2024
Diane Wellsandt Individual Corporate Director Jan 19, 2023
Kendall Schlake Individual Corporate Director Jan 16, 2025
Sara Stewart Individual Corporate Director Jan 19, 2023
Steven J Snyder Individual Corporate Director Jan 20, 2022
Dallas M Christ Individual Corporate Director Jan 20, 2022
Ross Boeckner Individual Corporate DirectorChairman Jan 1, 2020
Holly Wolff Individual Corporate OfficerCeo Jan 6, 2025
Adp of the SNF Jan 6, 2025
Chance Klasek Individual Corporate OfficerCfo Aug 24, 2013

Owners & managing parties with NPI records 5

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

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

Affiliated clinicians 2

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": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257292800000",
    "number": "1417198367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 H ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521119",
            "telephone_number": "402-729-3351",
            "fax_number": "402-729-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 H ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521119",
            "telephone_number": "402-729-3351",
            "fax_number": "402-729-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-11-04",
        "status": "A",
        "authorized_official_last_name": "JURGENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-729-3351"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "LTCH010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbury, NE

Sources for this page

Verify at the official NPI Registry.