NPIMap

Organization Active NPI

Pawnee Valley Community Hospital, Inc.

  • Specialist
  • Larned, KS
National Provider Identifier
1467569442
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PAWNEE VALLEY COMMUNITY HOSPITAL, INC.
Practice address
923 Carroll Ave
Larned, KS 67550-2429
Phone
(620) 285-3161
NPI assigned
Aug 24, 2006
Last updated
Dec 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Authorized official

Name
Mr. Edward Herrman
Title
President
Phone
(785) 623-5523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

923 Carroll Ave
Larned, KS 67550-2429

Mailing address

923 Carroll Ave
Larned, KS 67550-2429
Phone (620) 285-3161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614001374 KS Part B Supplier - Clinic/Group Practice 7315856473 Receives reassigned benefits from 27 practitioners
2 other NPIs on this enrollment
Practice locations: Larned, KS

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

713 W 11th St
Larned, KS 67550
Phone (620) 285-6958

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Pawnee Valley Community Hospital Family MedicineLarned, KS, CCN 178581 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2014
Jul 1, 2014

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577404800000",
    "number": "1467569442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 CARROLL AVE",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675502429",
            "telephone_number": "620-285-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 CARROLL AVE",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675502429",
            "telephone_number": "620-285-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWNEE VALLEY COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A",
        "authorized_official_last_name": "HERRMAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-623-5523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larned, KS

Sources for this page

Verify at the official NPI Registry.