NPIMap

Organization Active NPI

Hospital District No 1 Marion Co

  • Medicare Defined Swing Bed Hospital Unit
  • Marion, KS
National Provider Identifier
1619991072
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H057003 Issued in KS
Legal business name
HOSPITAL DISTRICT NO 1 MARION CO
Practice address
535 S Freeborn St
Marion, KS 66861-1256
Phone
(620) 382-2177
Fax
(620) 382-9104
NPI assigned
Jul 27, 2006
Last updated
Jan 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Alex Haines
Title
Ceo
Phone
(620) 382-2177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H057003 KS Primary

Addresses

Primary practice location

535 S Freeborn St
Marion, KS 66861-1256

Mailing address

535 S Freeborn St
Marion, KS 66861-1256
Phone (620) 382-2177

Other names 1

  • St. Luke Hospital Swing Bed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070227000313 KS Part A Provider - Critical Access Hospital 7517923196 Practice locations: Marion, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619991072. Details of each certification follow.

Hospital certification: CCN 17Z356

Legal name
HOSPITAL DISTRICT NO 1 MARION CO
Doing business as
ST LUKE HOSPITAL AND LIVING CENTER
Organization structure
OtherProprietary
Enrollment address
535 S Freeborn St
Marion, KS 66861-1256
Main/Primary Hospital Location

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
Hospital District No 1 Marion Co6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Ryan Edmundson Individual Corporate OfficerTreasurer Jun 24, 2025
Travis L Parmley Individual Corporate OfficerMember Jun 24, 2025
Roger Hannaford Individual Corporate DirectorMember Jun 27, 2023
Alex Haines Individual W-2 Managing EmployeeCeo Aug 30, 2023
Bev Reid Individual W-2 Managing EmployeeCfo Sep 30, 2015
Kathy Brenzikofer Individual Corporate DirectorMember Oct 30, 2023
Daniel Holub Individual Corporate DirectorSecretary Jun 23, 2023
Chris Mercer Individual Corporate DirectorVice Chairman Jun 22, 2021
Linda K Carlson Individual Corporate DirectorChairman Jun 29, 2011

Practitioners & affiliated clinicians

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1619991072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S FREEBORN ST",
            "city": "MARION",
            "state": "KS",
            "postal_code": "668611256",
            "telephone_number": "620-382-2177",
            "fax_number": "620-382-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S FREEBORN ST",
            "city": "MARION",
            "state": "KS",
            "postal_code": "668611256",
            "telephone_number": "620-382-2177",
            "fax_number": "620-382-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL DISTRICT NO 1 MARION CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-382-2177"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H057003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke Hospital Swing Bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marion, KS

Sources for this page

Verify at the official NPI Registry.