Meade Hospital District
Organization Active NPI Rural Health Clinic/Center · Meade, KS
NPI 1558367607 · NPPES record last updated Apr 15, 2021
Key facts
- NPI
- 1558367607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- MEADE HOSPITAL DISTRICT
- Practice address
- 119 N Hart
Meade, KS 67864-0001 - Phone
- (620) 873-2112
- NPI assigned
- Jun 23, 2005
- Organization subpart
- No
Authorized official
- Name
- Samantha Jo Benear
- Title
- Clinic Office Manager
- Phone
- (620) 873-7624
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 7
Practitioners 21
-
Natalie Roxanne Carrillo, FNP - BC
-
Jonathan Allan Bigler, P.A.
-
Thuy Nguyen, APRN
-
Jennifer Akins, PA
-
Ashley Ra-Nea Alvarez, APRN
-
Joseph P Clark, PA
-
Jeffrey P Flasschoen, PA-C
-
Paul J Jaster, MD
-
Jason Edward Kimm, FNP
-
Bambi Lee Lane, APRN
-
Gary B. Morsch, M.D.
-
Cooper L Nickel, M.D.
-
Naveen Penmasta, MD
-
Daniel Reimer, M.D.
-
Ronald Brent Williams, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Rural health clinic certification: CCN 178529
- Legal name
- MEADE HOSPITAL DISTRICT
- Doing business as
- MEADE RURAL HEALTH CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 1, 2005
- Last certification
- Nov 1, 2012
- Ownership / control type
- 2A
- Organization structure
- Government · Non-profit
- Enrollment address
- 119 N Hart
Box 820
Meade, KS 67864-0820 - Related CCNs
- 178529
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Stephanie Saucedo |
Corporate Officer | Feb 14, 2022 | |
| W-2 Managing Employee | Feb 14, 2022 | ||
| Operational/Managerial Control | Feb 14, 2022 | ||
| Loretta Ulichne |
Corporate Officer |
Jan 1, 2022 | |
| Dawn Unruh |
Corporate Officer |
Mar 27, 2023 | |
| W-2 Managing Employee |
Mar 27, 2023 | ||
| Operational/Managerial Control |
Mar 27, 2023 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Meade District Hospital |
Hospital | Operational/Managerial Control (100%) | Jul 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050317000553 | KS | Part a Provider - Rural Health Clinic | 4284609462 | Practice locations: Meade, KS |
National Provider Directory
- Tax ID family
- Meade Hospital Friend Care
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
119 N Hart
Meade, KS 67864-0001
Mailing address
PO Box 820
Meade, KS 67864-0820
Phone (620) 873-2141
Other names
- Meade Rural Health Clinic
Other providers in Meade, KS
- Meade County
- Meade County
- Meade District Hospital
- Meade District Hospital
- Meade Hospital District
- Meade Hospital District
- Meade Hospital District
- Meade Hospital District
- Meade Hospital District
- Meade Hospital Friend Care
All providers in Meade, KS · Rural Health Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.