NPIMap

Organization Active NPI

Pawnee Valley Community Hospital Inc

Doing business as Pawnee Valley Community Hospital Family Medicine

  • Rural Health Clinic/Center
  • Larned, KS
National Provider Identifier
1518394147
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PAWNEE VALLEY COMMUNITY HOSPITAL INC
Doing business as
Pawnee Valley Community Hospital Family Medicine
Practice address
713 W 11TH St
Larned, KS 67550-2055
Phone
(620) 804-6007
NPI assigned
Sep 27, 2013
Last updated
Apr 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Edward Herrman
Title
President & Ceo
Phone
(785) 623-5523

Specialties & licenses 1

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

Addresses

Primary practice location

713 W 11TH St
Larned, KS 67550-2055

Mailing address

713 W 11TH St
Larned, KS 67550-2055

Other names 1

  • Pawnee Valley Community Hospital Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610000482 KS Part A Provider - Rural Health Clinic 7315856473 Practice locations: Larned, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1518394147. Details of each certification follow.

Rural health clinic certification: CCN 178581

Legal name
PAWNEE VALLEY COMMUNITY HOSPITAL INC
Doing business as
PAWNEE VALLEY COMMUNITY HOSPITAL FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 5, 2014
Last certification
Jul 12, 2017
Ownership / control type
2B
Most recent change of ownership
Jul 1, 2014 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Nov 28, 2001 in KS
Enrollment address
713 W 11TH St
Larned, KS 67550-2055
Related CCNs
171345

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).

National Provider Directory

National Provider Directory
Tax ID family
Pawnee Valley Hospital Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

713 W 11th St
Larned, KS 67550
Phone (620) 285-6958

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Michelle Beckner Individual Corporate OfficerChief Financial Officer Nov 14, 2022
Shae C Veach Individual Corporate OfficerPresident Mar 1, 2010
Corporate DirectorBoard Member Mar 1, 2010
W-2 Managing EmployeeVP of Regional Operations Nov 29, 2010
Haysmed Partners Inc Organization, Hays, KS For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2014 100%
Hays Medical Center Inc Organization, Hays, KS Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2014 100%
Pawnee Valley Community Hospital Inc Organization, Larned, KS Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2014 100%
Operational/Managerial Control Jul 1, 2014 100%
Edward Herrman Individual Corporate Officer Oct 25, 2017
Corporate Director Oct 25, 2017
W-2 Managing Employee Oct 25, 2017

Owners & managing parties with NPI records 11

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

Facilities with the same owner 5

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

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1518394147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W 11TH ST",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675502055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W 11TH ST",
            "city": "LARNED",
            "state": "KS",
            "postal_code": "675502055",
            "telephone_number": "620-804-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAWNEE VALLEY COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "HERRMAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "785-623-5523"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pawnee Valley Community Hospital Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Larned, KS

Sources for this page

Verify at the official NPI Registry.