NPIMap

Organization Active NPI

Great Plains of Ellinwood, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Ellinwood, KS
National Provider Identifier
1487749602
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H005001 Issued in KS
Legal business name
GREAT PLAINS OF ELLINWOOD, INC.
Practice address
300 N Park Ave
Ellinwood, KS 67526-1452
Phone
(620) 564-2548
Fax
(620) 564-2491
NPI assigned
Oct 4, 2006
Organization subpart
Yes
Parent organization
GREAT PLAINS OF ELLINWOOD INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Mr. Kile Magner
Title
Chief Executive Officer
Phone
(620) 564-2548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H005001 KS Primary

Addresses

Primary practice location

300 N Park Ave
Ellinwood, KS 67526-1452

Mailing address

300 N Park Ave
Ellinwood, KS 67526-1452
Phone (620) 564-2548

Other identifiers 1

IdentifierTypeStateIssuer
001598OtherKSBCBS

Other names 1

  • Ellinwood District Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101013000312 KS Part A Provider - Critical Access Hospital 5092627539 Practice locations: Ellinwood, KS

Hospital certification: CCN 17Z301

Legal name
GREAT PLAINS OF ELLINWOOD INC
Doing business as
ELLINWOOD DISTRICT HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
300 N Park Ave
Ellinwood, KS 67526-1452
Hospital Swing-Bed Unit

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).

National Provider Directory

National Provider Directory
Tax ID family
Great Plains of Ellinwo2 organizations share this tax ID, including this one
Part of
Great Plains of Ellinwo

Other organizations with this tax ID 1

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

Locations

319 S Main St
Bushton, KS 67427
Phone (620) 562-3234

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Troy L Moore Individual Corporate OfficerCeo Feb 1, 2026
Great Plains Health Alliance Inc Organization, Wichita, KS Non-profit Operational/Managerial Control Apr 1, 2013
Rebecca Burns Individual W-2 Managing EmployeeHealth Info MGMT. Director Aug 27, 2000
Summer Zink Individual Corporate OfficerCfo Jul 1, 2016
W-2 Managing EmployeeCfo Jul 1, 2015
Curt Colson Individual Corporate DirectorVP Regional Operations Jan 2, 2015 5%

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1487749602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT PLAINS OF ELLINWOOD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT PLAINS OF ELLINWOOD INC.",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "MAGNER",
        "authorized_official_first_name": "KILE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "620-564-2548",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H005001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001598",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellinwood District Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellinwood, KS

Sources for this page

Verify at the official NPI Registry.