NPIMap

Organization Active NPI

Dundy County Hospital

  • Rural Health Clinic/Center
  • Stratton, NE
National Provider Identifier
1477640985
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DUNDY COUNTY HOSPITAL
Practice address
903 Bailey St
Stratton, NE 69043-5121
Phone
(308) 276-2411
Fax
(308) 276-2415
NPI assigned
Oct 6, 2006
Organization subpart
Yes
Parent organization
DUNDY COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Jeremiah W Hanes
Title
Ceo
Phone
(308) 423-2204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

903 Bailey St
Stratton, NE 69043-5121

Mailing address

PO Box 710
Benkelman, NE 69021-0710
Phone (308) 423-2151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040810000588 NE Part B Supplier - Clinic/Group Practice 1153239777 Receives reassigned benefits from 20 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benkelman, NE; Imperial, NE; Wauneta, NE
O20061115000331 NE Part A Provider - Rural Health Clinic 1153239777 Practice locations: Stratton, NE

Rural health clinic certification: CCN 283441

Legal name
DUNDY COUNTY HOSPITAL
Doing business as
QUALITY HEALTHCARE SERVICES MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 8, 1997
Last certification
Jan 4, 2022
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
903 Bailey St
Stratton, NE 69043-5121
Related CCNs
281340

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

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 3

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

National Provider Directory

National Provider Directory
Part of
Dundy Co Hospital ER

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Alicia Aldridge Individual W-2 Managing EmployeeCfo Apr 11, 2019
Operational/Managerial ControlCfo Apr 11, 2019
Scott L Stahlecker Individual Corporate Director Nov 16, 2020
Rodney D Damrow Individual Corporate Officer Mar 1, 2015
Corporate Director Mar 1, 2013
Shane N Sis Individual Corporate Officer Sep 17, 2021
Corporate Director Jul 1, 2020
Helen L McSwain Individual W-2 Managing EmployeeAd;Director of Clinic Services May 2, 2019
Operational/Managerial ControlDirector of Clinic Services May 2, 2019
Robin a Shaw Individual Corporate Officer Mar 1, 2022
Corporate Director Sep 20, 2021
Jennifer J Brown Individual Corporate Director Jul 26, 2022
Jose R Garcia Individual W-2 Managing EmployeeMD; Jul 17, 2018
Operational/Managerial ControlMedical Director Jul 17, 2018
Jeremiah W Hanes Individual Corporate OfficerCeo Oct 14, 2024
W-2 Managing EmployeeCeo Oct 14, 2024
Operational/Managerial ControlCeo Oct 14, 2024

Owners & managing parties with NPI records 1

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1477640985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "BENKELMAN",
            "state": "NE",
            "postal_code": "690210710",
            "telephone_number": "308-423-2151",
            "fax_number": "308-423-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BAILEY ST",
            "city": "STRATTON",
            "state": "NE",
            "postal_code": "690435121",
            "telephone_number": "308-276-2411",
            "fax_number": "308-276-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNDY COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNDY COUNTY HOSPITAL",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "HANES",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-423-2204"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratton, NE

Sources for this page

Verify at the official NPI Registry.