NPIMap

Organization Active NPI

Avera St Anthonys Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Oneill, NE
National Provider Identifier
1598878472
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
410002 Issued in NE
Legal business name
AVERA ST ANTHONYS HOSPITAL
Practice address
300 North 2ND St
Oneill, NE 68763-1514
Phone
(402) 336-2611
Fax
(402) 336-5135
NPI assigned
Aug 16, 2006
Organization subpart
Yes
Parent organization
AVERA ST ANTHONYS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Mr. Todd E. Consbruck
Title
Ceo
Phone
(402) 336-2611

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 410002 NE Primary
Critical Access Hospital 282NC0060X 410002 NE

Addresses

Primary practice location

300 North 2ND St
Oneill, NE 68763-1514

Mailing address

PO Box 270
Oneill, NE 68763-0270
Phone (402) 336-5154

Other names 1

  • Avera St. Anthony's Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111217000009 NE Part A Provider - Critical Access Hospital 4486548203 Practice locations: Oneill, NE

Hospital certification: CCN 28Z329

Legal name
AVERA ST ANTHONYS HOSPITAL
Doing business as
AVERA ST ANTHONYS HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jul 25, 1963 in NE
Enrollment address
300 N 2ND St
Oneill, NE 68763-1514

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
St Anthonys Hosp Card Dep8 organizations share this tax ID, including this one
Part of
St Anthonys Hosp Card Dep

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
James Francis Dover Individual Corporate OfficerFache, President/Ceo Avera Health Oct 23, 2023
Russell J McIntosh Individual Corporate DirectorBoard Member Jul 1, 2020
John Kozyra Individual Corporate OfficerPresident/Ceo Jan 29, 2024
Operational/Managerial ControlPresident/Ceo Jan 29, 2024
Jewel Swanson Individual Corporate DirectorBoard Member Jul 1, 2023
Debra L Kelly Individual Corporate DirectorBoard Member Jul 1, 2020
Amanda Marie Schutz Individual Corporate OfficerOfficer Billing Services Jun 18, 2018
Susan Dennis Individual Corporate DirectorBoard Member Jul 1, 2022
Barton Becker Individual Corporate DirectorBoard Member Jul 1, 2021
Sacred Heart Health Services Organization, Yankton, SD Management services company, Non-profit Operational/Managerial Control Feb 1, 1998
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Bonita Gacnik Individual Corporate DirectorBoard Member Jul 1, 2022
Avera Health Organization, Sioux Falls, SD Corporation, Management services company, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2000 100%
Operational/Managerial Control Sep 1, 2000
Amy Shane Individual Corporate DirectorBoard Member Jul 1, 2020
Cody Boettcher Individual Corporate DirectorBoard Member Jul 1, 2023
Merri Schneider Individual Corporate DirectorBoard Member Jul 1, 2020
Mark Hunhoff Individual Corporate DirectorBoard Member Jul 1, 2023

Owners & managing parties with NPI records 18

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

View all 18

Facilities with the same owner 96

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

View all 96

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

Affiliated clinicians 5

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1598878472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687630270",
            "telephone_number": "402-336-5154",
            "fax_number": "402-336-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH 2ND ST",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631514",
            "telephone_number": "402-336-2611",
            "fax_number": "402-336-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST ANTHONYS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVERA ST ANTHONYS HOSPITAL",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "CONSBRUCK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-336-2611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "410002",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "410002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera St. Anthony's Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera St. Anthony's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oneill, NE

Sources for this page

Verify at the official NPI Registry.