NPIMap

Organization Active NPI

Community Memorial Healthcare, Inc.

Doing business as Community Memorial Healthcare - CRNA

  • Certified Registered Nurse Anesthetist
  • Marysville, KS
National Provider Identifier
1487660809
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
COMMUNITY MEMORIAL HEALTHCARE, INC.
Doing business as
Community Memorial Healthcare - CRNA
Practice address
708 N 18TH St
Marysville, KS 66508-1338
Phone
(785) 562-2311
Fax
(785) 562-2348
NPI assigned
Jul 31, 2006
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Tom Hood
Title
Interim Ceo
Phone
(785) 562-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

708 N 18TH St
Marysville, KS 66508-1338

Mailing address

708 N 18TH St
Marysville, KS 66508-1338
Phone (785) 562-2311

Other identifiers 1

IdentifierTypeStateIssuer
012260OtherKSBC/BS KS

Other names 1

  • Community Memorial Healthcare - CRNA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000181 KS Part B Supplier - Clinic/Group Practice 6608763503 Receives reassigned benefits from 14 practitioners
6 other NPIs on this enrollment
Practice locations: Marysville, KS; Axtell, KS; Blue Rapids, KS

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Physicians CL11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

708 N 18th St
Marysville, KS 66508
Phone (785) 562-2311

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1487660809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 N 18TH ST",
            "city": "MARYSVILLE",
            "state": "KS",
            "postal_code": "665081338",
            "telephone_number": "785-562-2311",
            "fax_number": "785-562-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 N 18TH ST",
            "city": "MARYSVILLE",
            "state": "KS",
            "postal_code": "665081338",
            "telephone_number": "785-562-2311",
            "fax_number": "785-562-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "785-562-2311"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS KS",
            "identifier": "012260",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Memorial Healthcare - CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; 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.