NPIMap

Organization Active NPI

Grand Island Regional Medical Center

  • General Acute Care Hospital
  • Grand Island, NE
National Provider Identifier
1558910604
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
GRAND ISLAND REGIONAL MEDICAL CENTER
Practice address
3533 Prairieview St
Grand Island, NE 68803-4409
Phone
(308) 233-2688
NPI assigned
Sep 10, 2019
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Andrew P Waterman
Title
Ceo
Phone
(308) 675-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

3533 Prairieview St
Grand Island, NE 68803-4409

Mailing address

PO Box 5225
Grand Island, NE 68802-5225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200406002054 NE Part A Provider - Hospital 0143659508 Practice locations: Grand Island, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558910604. Details of each certification follow.

Hospital certification: CCN 280139

Legal name
GRAND ISLAND REGIONAL MEDICAL CENTER
Doing business as
GRAND ISLAND REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 1, 2020
Last certification
Aug 1, 2020
Beds
67
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 2017 in NE
Enrollment address
3533 Prairieview Street
Grand Island, NE 68803-4409
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Grand Island Regional Medical CenterCCN 280139 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Grand Island Regional Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Gregory S Sextro Individual Corporate Director Jan 1, 2024
Teresa a Grabowski Individual Corporate Director Jan 1, 2023
Krista M Stoecker Individual Corporate Director Jan 1, 2024
Andrew P Waterman Individual Corporate OfficerPresident & Ceo Dec 31, 2023
W-2 Managing EmployeePresident & Ceo Jan 22, 2018
Operational/Managerial ControlPresident & Ceo Jan 22, 2018
Cindy Johnson Individual Corporate Officer Jan 24, 2023
Corporate Director Feb 23, 2021
Ryan D Crouch Individual Corporate Officer Jan 24, 2023
Corporate Director Feb 18, 2019
Thomas Frederick Werner Individual Corporate Director Feb 18, 2019
Bryan Health Organization, Lincoln, NE Corporation, Non-profit, Chain home office Operational/Managerial Control Dec 5, 2017
Tracy Schmitt Individual W-2 Managing EmployeeCfo Nov 4, 2024
Operational/Managerial ControlCfo Nov 4, 2024
John T Woodrich Individual Corporate Director Feb 18, 2019
Russell R Gronewold Individual Corporate Director Feb 18, 2019
Molly Ann Johnson Individual Corporate Director Feb 18, 2019

Owners & managing parties with NPI records 5

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 96

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 96

Affiliated clinicians 177

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

View all 177

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1558910604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5225",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 PRAIRIEVIEW ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034409",
            "telephone_number": "308-233-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND ISLAND REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-675-5000"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.