NPIMap

Organization Active NPI

West Central Kansas Association Inc.

Doing business as Russell Regional Hospital

  • General Acute Care Hospital
  • Russell, KS
National Provider Identifier
1417939729
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H084001 Issued in KS
Legal business name
WEST CENTRAL KANSAS ASSOCIATION INC.
Doing business as
Russell Regional Hospital
Practice address
200 S Main St
Russell, KS 67665-2920
Phone
(785) 483-3131
NPI assigned
Nov 14, 2005
Last updated
Nov 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
David Caudill
Title
Ceo
Phone
(785) 483-0708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H084001 KS Primary

Addresses

Primary practice location

200 S Main St
Russell, KS 67665-2920

Mailing address

200 S Main St
Russell, KS 67665-2920
Phone (785) 483-3131

Other identifiers 2

IdentifierTypeStateIssuer
100306710AMedicaidKS
000076OtherKSBCBS

Other names 1

  • Russell Regional Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000836 KS Part B Supplier - Clinic/Group Practice 4981512001 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Russell, KS
O20061104000447 KS Part A Provider - Critical Access Hospital 4981512001 Receives reassigned benefits from 24 practitioners
Practice locations: Russell, KS

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1417939729. Details of each certification follow.

Hospital certification: CCN 171350

Legal name
WEST CENTRAL KANSAS ASSOCIATION INC
Doing business as
RUSSELL REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2002
Last certification
Sep 9, 2016
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
200 S Main St
Russell, KS 67665-2920
Other Hospital Practice Location

Hospital certification: CCN 170030

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RUSSELL REGIONAL HOSPITAL
Certification status
Terminated Other: provider status change, Dec 1, 2002
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 30, 2002
Beds
34
Ownership / control type
Other
Facility address
200 S Main
Russell, KS 67665

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

Other NPIs with the same Medicare PAC ID 2

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
Russell Regional HospitalCCN 171350 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
David P Caudill Individual Corporate DirectorCeo Jul 19, 2021
W-2 Managing EmployeeCeo Jul 19, 2021
Molly Friebus Individual Corporate DirectorAsst Business Office Director Nov 1, 2017
Kalena N Coleman Individual Corporate DirectorBusiness Office Directoe Jul 21, 2017

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

Affiliated clinicians 85

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1417939729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676652920",
            "telephone_number": "785-483-3131",
            "fax_number": "785-483-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MAIN ST",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676652920",
            "telephone_number": "785-483-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CENTRAL KANSAS ASSOCIATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-483-0708"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "KS",
            "license": "H084001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100306710A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000076",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russell Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Russell Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russell, KS

Sources for this page

Verify at the official NPI Registry.