NPIMap

St. Mary'S Community Hospital

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Nebraska City, NE

NPI 1497801567 · NPPES record last updated Feb 10, 2022

Key facts

NPI
1497801567
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
H000128 (NE)
Legal business name
ST. MARY'S COMMUNITY HOSPITAL
Practice address
1301 Grundman Blvd
Nebraska City, NE 68410-3323
Phone
(402) 873-8951
Fax
(402) 873-9033
NPI assigned
Jan 25, 2007
Organization subpart
No

Authorized official

Name
Evert Kuiper
Title
Ceo - CHI Health
Phone
(402) 343-4420

Owners & managing parties with NPI records 3

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

Other NPIs with the same Medicare PAC ID 2

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

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

Facilities with the same owner 38

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

View all 38

Practitioners 27

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

View all 27

Affiliated clinicians 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

Hospital certification: CCN 28Z342

Legal name
ST MARYS COMMUNITY HOSPITAL
Doing business as
CHI HEALTH ST MARYS
Organization structure
Corporation · Non-profit
Enrollment address
1301 Grundman Blvd
Nebraska City, NE 68410-3319
Other Hospital Practice Location

All disclosed owners & managing parties 13

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

NameRoleSinceShare
CHI Nebraska
Organization · Omaha, NE
Corporation, Non-profit, Owned by another organization or individual 		5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Commonspirit Health
Organization · Englewood, CO
Corporation, Non-profit, Chain home office 		5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
Daniel J Defreece
Individual 		Operational/Managerial Control
President		 May 13, 2018
Cindy a Alloway
Individual 		Corporate Director
Board Member		 Jul 1, 2023
Tim Bricker
Individual 		Corporate Officer
Region President		 Jul 1, 2023
Corporate Director
Board Member		 Jul 1, 2023
William Barney
Individual 		Corporate Director Jul 1, 2020
Kevin Fitzgerald
Individual 		Corporate Director
Bod		 Jul 15, 2021
Nick O'Tool
Individual 		Corporate Officer
Market Cfo		 Jan 7, 2023
W-2 Managing Employee
Market Cfo		 Jan 7, 2023
Operational/Managerial Control
Market Cfo		 Jan 7, 2023
Heather M Morgan
Individual 		Corporate Director Jul 1, 2020
Kirtibala Gupta
Individual 		Corporate Director
Bod		 Jul 15, 2021
John E Petersdorf
Individual 		Corporate Director Jan 21, 2021
Mardell Wilson
Individual 		Corporate Director Oct 15, 2020
Kelly Bacon
Individual 		Corporate Director
Bod		 Jul 15, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071128000892 NE Part a Provider - Critical Access Hospital 7113831926 Practice locations: Nebraska City, NE

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H000128 NE Yes
Critical Access Hospital 282NC0060X H000128 NE

Addresses

Primary practice location

1301 Grundman Blvd
Nebraska City, NE 68410-3323

Mailing address

1301 Grundman Blvd
Nebraska City, NE 68410-3323
Phone (402) 873-8951

Other names

  • CHI Health St. Mary's Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 10, 2022.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1497801567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103323",
            "telephone_number": "402-873-8951",
            "fax_number": "402-873-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103323",
            "telephone_number": "402-873-8951",
            "fax_number": "402-873-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO - CHI HEALTH",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "H000128",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "H000128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health St. Mary's",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health St. Mary's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nebraska City, NE

All providers in Nebraska City, NE · Medicare Defined Swing Bed Hospital Unit in Nebraska

Sources for this page

Verify at the official NPI Registry.