Active NPI
Bethel Home, Inc.
- Nursing Facility/Intermediate Care Facility
- Montezuma, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- N035001
- Legal business name
- BETHEL HOME, INC.
- Practice address
- 300 S Aztec St
Montezuma, KS 67867-8811 - Phone
- (620) 846-2241
- Fax
- (620) 846-2149
- NPI assigned
- Nov 15, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Merle Koehn
- Title
- Administrator
- Phone
- (620) 846-2241
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | N035001 | KS | Primary |
Addresses
Primary practice location
300 S Aztec St
Montezuma, KS 67867-8811
Mailing address
300 S Aztec St
Montezuma, KS 67867-8811
Phone (620) 846-2241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170512001677 | KS | Part A Provider - Skilled Nursing Facility | 0446537831 | Practice locations: Montezuma, KS |
Skilled nursing facility certification: CCN 175528
- Legal name
- BETHEL HOME INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 28, 2012
- Last certification
- Jan 16, 2025
- Beds
- 56
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Enrollment address
- 300 S Aztec St
Montezuma, KS 67867-8811 - Nursing home name
- BETHEL HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bethel Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Aug 28, 2012
- Medicare certification status
- Active
- Certified beds
- 56
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David Unruh | Corporate Director | Jan 1, 2019 | |
| Andrew W Schowengerdt | Corporate Director | Aug 1, 1991 | |
| Operational/Managerial Control | Aug 1, 1991 | ||
| Adp of the SNF | Aug 1, 1991 | ||
| Chris Yost | Corporate Director | Jan 1, 2024 | |
| Eugene Koehn | Corporate Officer | Jan 1, 2018 | |
| Brian Koehn | Operational/Managerial Control | Mar 13, 2018 | |
| Adp of the SNF | Mar 13, 2018 | ||
| Lennis Koehn | Corporate Director | Jan 1, 2018 | |
| Terry Ensz | Corporate Officer | Jan 1, 2021 | |
| Presley Koehn | Corporate Director | Jan 1, 2024 | |
| Travis Isaac | Corporate Director | Jan 1, 2022 | |
| Brenton Nickel | Corporate Director | Jan 1, 2024 | |
| James Smith | Corporate Officer | Jan 1, 2021 | |
| Lance Johnson | Corporate Director | Jan 1, 2023 | |
| Brandon Unruh | Corporate Director | Jan 1, 2023 | |
| Don Koehn | Corporate Director | Jan 1, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Montezuma, KS
- NPI 1881676112
Adp of the SNF, Corporate Director, Operational/Managerial 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.
-
- Family Medicine Physician
- Montezuma, KS
- NPI 1881676112
Affiliated clinicians 1
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": "1132012800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1528040797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 S AZTEC ST",
"city": "MONTEZUMA",
"state": "KS",
"postal_code": "678678811",
"telephone_number": "620-846-2241",
"fax_number": "620-846-2149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S AZTEC ST",
"city": "MONTEZUMA",
"state": "KS",
"postal_code": "678678811",
"telephone_number": "620-846-2241",
"fax_number": "620-846-2149"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BETHEL HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KOEHN",
"authorized_official_first_name": "MERLE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "620-846-2241",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "KS",
"license": "N035001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montezuma, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.