Hospital District No 1 of Rice Co
Organization Active NPI Rural Health Clinic/Center · Lyons, KS
NPI 1588933352 · NPPES record last updated Oct 31, 2023
Key facts
- NPI
- 1588933352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- HOSPITAL DISTRICT NO 1 OF RICE CO
- Practice address
- 1221 W Noble St
Lyons, KS 67554-3026 - Phone
- (620) 257-5124
- Fax
- (620) 257-5128
- NPI assigned
- Dec 22, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- HOSPITAL DISTRICT NO 1 OF RICE CO
Authorized official
- Name
- Weston Tallman
- Title
- Cfo
- Phone
- (620) 257-5173
Owners & managing parties with NPI records 3
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 3
Related certifications (CCN) 1
Facilities with the same owner 1
Practitioners 14
-
Lora Rose Bebermeyer, PA-C
-
Paul Casper, PA
-
Melissa Megan Conard, APRN
-
James D Decker, DO
-
Allison Edwards, APRN
-
Alisha Renae Koch, ARNP
-
Karen Lee Root, NP
-
Alisha Stinemetz, APRN
-
Stacy Leila Dashiell, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Rural health clinic certification: CCN 178568
- Legal name
- HOSPITAL DISTRICT NO 1 OF RICE CO
- Doing business as
- LYONS MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 1, 2012
- Last certification
- Oct 1, 2015
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 1221 W Noble St
Lyons, KS 67554-3026 - Related CCNs
- 171330
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Linda Brunk |
Corporate Officer | Jan 1, 2017 | |
| Hospital District No 1 of Rice Co |
5% Or Greater Direct Ownership Interest | Jan 1, 2012 | 100% |
| Weston Tallman |
Corporate Officer |
Jul 31, 2023 | |
| Corporate Director |
Jul 31, 2023 | ||
| W-2 Managing Employee |
Jul 31, 2023 | ||
| Gayla Schubert |
Corporate Officer |
Mar 15, 2021 | |
| Sheri L Bennett |
Corporate Director | Sep 15, 2008 | |
| Marcia Diasio |
Corporate Officer |
Mar 15, 2021 | |
| George M Stover |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee |
Jan 1, 2012 | ||
| Terry L David |
Corporate Director | Dec 28, 2016 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospital District No 1 of Rice Co |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Oct 6, 2006 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000596 | KS | Part B Supplier - Clinic/Group Practice | 0648175042 |
Receives reassigned benefits from 36 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lyons, KS; Sterling, KS |
| O20120326000061 | KS | Part a Provider - Rural Health Clinic | 0648175042 | Practice locations: Lyons, KS |
National Provider Directory
- Part of
- Hospital District No 1 of Rice Co
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | H080001 | KS | |
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1221 W Noble St
Lyons, KS 67554-3026
Mailing address
PO Box 828
Lyons, KS 67554-0828
Phone (620) 257-5173
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30003942210005 | Medicaid | KS | |
| 100099160A | Medicaid | KS |
Other names
- Lyons Medical Center
Other providers in Lyons, KS
- Kent Wayne Hanson
- Hogan'S Pharmacy, Inc
- Hospital District No 1 of Rice Co
- Hospital District No 1 of Rice Co
- Hospital District No 1 of Rice Co
- Hospital District No 1 of Rice Co
- Hospital District No 1 of Rice Co
- Hutchinson Clinic, P.a., Inc.
- Vicki Johnston
- Amber Kaspar
All providers in Lyons, 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 Oct 31, 2023. 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.