NPIMap

Organization Active NPI

Pratt Regional Medical Center Corporation

  • Home Health Agency
  • Pratt, KS
National Provider Identifier
1508948449
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRATT REGIONAL MEDICAL CENTER CORPORATION
Practice address
200 Commodore St
Pratt, KS 67124-2903
Phone
(620) 672-7451
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Susan Page
Title
President & Ceo
Phone
(620) 672-7451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

200 Commodore St
Pratt, KS 67124-2903

Mailing address

200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-7451

Other names 1

  • Pratt Regional Medical Center Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060104000810 KS Part A Provider - Home Health Agency 1355253238 Practice locations: Pratt, KS

Home health agency certification: CCN 178000

Legal name
PRATT REGIONAL MEDICAL CENTER CORPORATION
Doing business as
PRATT REGIONAL MEDICAL CENTER HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 9, 1996
Last certification
Jan 24, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Enrollment address
200 Commodore St
Pratt, KS 67124-2903

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Pratt Regional Medical Center HHACCN 178000
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Feb 9, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Maxine a Lingurar MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Pratt Regional Medical Center Corporation Organization, Pratt, KS Non-profit Operational/Managerial Control Oct 22, 2014
Tammy Smith Individual Corporate DirectorCeo Jul 15, 2022 50%
W-2 Managing EmployeeCeo Jul 15, 2022 50%
Gary D Barker Individual Corporate DirectorBoard Member Jan 1, 2012
Suzanne Moore Individual Corporate Director Jan 1, 2021
Scott W Gordon Individual Corporate Director Jan 1, 2021
Josh Nicolay Individual Corporate Director Apr 1, 2023
William K Keller Individual Corporate DirectorChairman Jan 1, 2012
John W Fowler Individual Corporate Director Aug 13, 2009
Nicole Griffith Individual W-2 Managing EmployeeController Aug 1, 2021
Shelly Little Individual Corporate Director Jun 24, 2024
Jeanette M Siemens Individual Corporate DirectorBoard Member Jan 1, 2012
Tonya Powell Individual Corporate OfficerInterim Cfo Nov 22, 2024
Luis E Espinoza Individual Corporate Director Jan 1, 2024
Dakota Holtgrieve Individual Corporate Director Jan 1, 2021
Donna McEachern Individual Corporate Director Jan 1, 2025
Becca Flowers Individual Corporate DirectorBoard Member Jan 1, 2012

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Pratt Regional Medical CenterPratt, KS, CCN 17U027 Hospital Operational/Managerial Control Jul 1, 2015
Pratt Internal Medicine GroupPratt, KS, CCN 178583 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 11

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": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1508948449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT REGIONAL MEDICAL CENTER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "620-672-7451"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pratt Regional Medical Center Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pratt, KS

Sources for this page

Verify at the official NPI Registry.