NPIMap

Organization Active NPI

Phelps Memorial Health Center

  • Critical Access Hospital
  • Holdrege, NE
National Provider Identifier
1629035936
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
610003 Issued in NE
Legal business name
PHELPS MEMORIAL HEALTH CENTER
Practice address
1215 Tibbals St
Holdrege, NE 68949-1255
Phone
(308) 995-2211
Fax
(308) 995-3223
NPI assigned
Apr 28, 2006
Last updated
Jun 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Mr. Mark D Harrel
Title
Ceo
Phone
(308) 995-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 610003 NE Primary

Addresses

Primary practice location

1215 Tibbals St
Holdrege, NE 68949-1255

Mailing address

1215 Tibbals St
Holdrege, NE 68949-1255
Phone (308) 995-2211

Other identifiers 5

IdentifierTypeStateIssuer
00097OtherNEBCBS HOSPITAL
N002951OtherTRICARE HOSPITAL
142918400OtherUS DEPT OF LABOR
100099700AMedicaidKS
40-4784043MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000753 NE Part A Provider - Critical Access Hospital 9931011947 Receives reassigned benefits from 95 practitioners
Practice locations: Holdrege, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629035936. Details of each certification follow.

Hospital certification: CCN 281362

Legal name
PHELPS MEMORIAL HEALTH CENTER
Doing business as
PHELPS MEMORIAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2005
Last certification
Jul 25, 2013
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 12, 1963 in NE
Enrollment address
1215 Tibbals St
Holdrege, NE 68949-1255

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Phelps Memorial Health CenterCCN 281362 · All quality measures
Overall star rating
4 of 5
Type
Critical Access 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
Phelps Memorial Health CT3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: charleschristie@pmhc.medalliesdirect.net
  • Direct secure messaging: charlottewirges@pmhc.medalliesdirect.net
  • Direct secure messaging: connielans@pmhc.medalliesdirect.net
  • Direct secure messaging: jeffreyberney@pmhc.medalliesdirect.net
  • Direct secure messaging: jodypfeifer@pmhc.medalliesdirect.net
  • Direct secure messaging: katieluthy@pmhc.medalliesdirect.net
  • Direct secure messaging: madisonnott@pmhc.medalliesdirect.net
  • Direct secure messaging: scottehresman@pmhc.medalliesdirect.net
  • Direct secure messaging: shanesmith@pmhc.medalliesdirect.net
  • Direct secure messaging: thomassmith@pmhc.medalliesdirect.net
  • Direct secure messaging: williamsandy@pmhc.medalliesdirect.net

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Loren D Schroder Individual Corporate OfficerCfo Aug 6, 2018
W-2 Managing EmployeeCfo Aug 1, 2018
Operational/Managerial ControlCfo Dec 1, 2001
Michael L Pelster Individual Corporate Officer May 6, 2019
Corporate Director Apr 18, 2017
Mark R Kraus Individual Corporate Director Jun 2, 2020
Donald D Kraus Individual Corporate Director Apr 18, 2023
Kyle L Anderson Individual Corporate Officer Oct 2, 2023
Corporate Director Apr 12, 2022
Lance a Thorell Individual Corporate Director Nov 6, 2023
Howard S Kness Individual Corporate Officer Apr 21, 2022
Corporate Director Apr 16, 2020
Douglas M Hohman Individual Corporate Director Apr 18, 2023
Linda Jo Heiden Individual Corporate Officer Oct 2, 2023
Corporate Director Apr 12, 2022
Heather K McQuillan Individual Corporate Director Apr 18, 2023
Stephanie Dannehl Individual Corporate Director Apr 13, 2021
William M Sandy Individual Corporate Director Apr 16, 2024
Jeffrey R Berney Individual Corporate Director Jan 1, 2023
Operational/Managerial ControlChief of Staff Jan 1, 2023
Mark D Harrel Individual Corporate OfficerCeo Aug 6, 2018
W-2 Managing EmployeeCeo Aug 1, 2018
Operational/Managerial ControlCeo Jul 9, 2007

Owners & managing parties with NPI records 3

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

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 100

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 100

Affiliated clinicians 119

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

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1629035936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 TIBBALS ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491255",
            "telephone_number": "308-995-2211",
            "fax_number": "308-995-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 TIBBALS ST",
            "city": "HOLDREGE",
            "state": "NE",
            "postal_code": "689491255",
            "telephone_number": "308-995-2211",
            "fax_number": "308-995-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHELPS MEMORIAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "HARREL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-995-2211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "610003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOSPITAL",
            "identifier": "00097",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE HOSPITAL",
            "identifier": "N002951",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "142918400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100099700A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40-4784043",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holdrege, NE

Sources for this page

Verify at the official NPI Registry.