NPIMap

Organization Active NPI

Columbus Community Hospital Inc

Doing business as CCH Professional Services

  • Emergency Medicine Physician
  • Columbus, NE
National Provider Identifier
1427152131
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
COLUMBUS COMMUNITY HOSPITAL INC
Doing business as
CCH Professional Services
Practice address
4600 38TH St
Columbus, NE 68601-1664
Phone
(402) 564-7118
Fax
(402) 562-3378
NPI assigned
Sep 12, 2006
Last updated
Jul 24, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBUS COMMUNITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

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

Authorized official

Name
Mr. Chad E Van Cleave
Title
Vice-President Finance
Phone
(402) 564-7118

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Certified Registered Nurse Anesthetist 367500000X NU
Registered Dietitian 133V00000X NU
Emergency Medicine Physician 207P00000X NU Primary
Psychiatry Physician 2084P0800X NU
Geriatric Psychiatry Physician 2084P0805X NU

Addresses

Primary practice location

4600 38TH St
Columbus, NE 68601-1664

Mailing address

PO Box 1800
Columbus, NE 68602-1800
Phone (402) 564-7118

Other identifiers 6

IdentifierTypeStateIssuer
119099OtherNECOVENTRY (CRNA) GROUP #
03417OtherNEBCBS NE (LOCUMS) GRP #
81052OtherNEBCBS NE (CDE) GRP #
08554OtherNEBCBS NE (CRNA) GRP #
H123OtherNEMIDLANDS CHOICE GRP #
84476OtherNECOVENTRY (ER) GROUP #

Other names 1

  • CCH 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
O20040428000541 NE Part B Supplier - Clinic/Group Practice 7517954944 Receives reassigned benefits from 90 practitioners
Practice locations: Kenesaw, NE; Lincoln, NE; David City, NE; Omaha, NE; Roca, NE; Schuyler, NE; Hastings, NE; Columbus, NE…

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Part of
South Sioux City Medica

Locations

4508 38th St
Ste 165
Columbus, NE 68601
Phone (402) 562-4444

Ownership & related parties

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 94

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 94

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627084800000",
    "number": "1427152131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1800",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686021800",
            "telephone_number": "402-564-7118",
            "fax_number": "402-562-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 38TH ST",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686011664",
            "telephone_number": "402-564-7118",
            "fax_number": "402-562-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "enumeration_date": "2006-09-12",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A",
        "authorized_official_last_name": "VAN CLEAVE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE-PRESIDENT FINANCE",
        "authorized_official_telephone_number": "402-564-7118",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY (CRNA) GROUP #",
            "identifier": "119099",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE (LOCUMS) GRP #",
            "identifier": "03417",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE (CDE) GRP #",
            "identifier": "81052",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE (CRNA) GRP #",
            "identifier": "08554",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE GRP #",
            "identifier": "H123",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY (ER) GROUP #",
            "identifier": "84476",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.