Edwards County Hospital and Healthcare Center
Organization Active NPI Rural Health Clinic/Center · Kinsley, KS
NPI 1649372012 · NPPES record last updated Aug 30, 2022
Key facts
- NPI
- 1649372012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 173495 (KS)
- Legal business name
- EDWARDS COUNTY HOSPITAL AND HEALTHCARE CENTER
- Practice address
- 620 W 8TH St
Kinsley, KS 67547-2329 - Phone
- (620) 659-3621
- Fax
- (620) 659-3869
- NPI assigned
- Sep 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Jimmie Hansel
- Title
- Chief Executive Officer
- Phone
- (620) 659-3621
Owners & managing parties with NPI records 3
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 3
Member organizations 1
Related certifications (CCN) 1
Facilities with the same owner 1
Practitioners 30
-
Fredrick J Farmer III, D.O.
-
Margaret A. Myers, APRN
-
Darnell B Ganley, P.A.
-
Lisa R Stuckey, PA-C
-
Kathy Lenay Wyer, NP-C
-
Trent Dylan Befort, APRN
-
John Andrew Bukaty, D.O.
-
Jenifer P Cook, MD
-
Stephanie Jean Jones, CRNA
-
Timothy W Lawton, MD
-
Gary B. Morsch, M.D.
-
Naveen Penmasta, MD
-
Timothy A Hanson, CRNA
-
Vincent Ombongi Mogoi, APRN
-
Aaron Christian Branch, M.D.
-
Jennifer Akins, PA
-
Spencer Charles Anderson, PA-C
-
Daren L. Badura, MPA
-
Trent Colin Blackwill, CRNA, DNAP
-
Craig Copelin, C.R.N.A.
-
Brian Joseph Jennings, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2322710 | Midway Clinic | Certificate of waiver | Apr 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Rural health clinic certification: CCN 173495
- Legal name
- EDWARDS COUNTY HOSPITAL AND HEALTHCARE CENTER
- Doing business as
- MIDWAY CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 6, 2000
- Last certification
- Oct 1, 2014
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 604 W 8TH St
Kinsley, KS 67547-2329 - Related CCNs
- 171317
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Edwards County Hospital and Healthcare Center |
5% Or Greater Direct Ownership Interest | Mar 1, 2018 | 100% |
| Michele Morris |
W-2 Managing Employee | Mar 1, 2024 | |
| Jimmie Hansel |
W-2 Managing Employee |
Jul 1, 2016 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Spearville Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 4, 2019 Aug 24, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030917000019 | KS | Part a Provider - Rural Health Clinic | 2264343383 | Practice locations: Kinsley, KS |
| O20040305000254 | KS | Part B Supplier - Clinic/Group Practice | 2264343383 |
Receives reassigned benefits from 23 practitioners 5 other NPIs on this enrollment Practice locations: Kinsley, KS; Spearville, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 173495 | KS | Yes |
Addresses
Primary practice location
620 W 8TH St
Kinsley, KS 67547-2329
Mailing address
620 W 8TH St
Kinsley, KS 67547-2329
Phone (620) 659-3621
Other practice location 1
205 Hall St
Spearville, KS 67876-8553
Phone (620) 385-2963
Other practice location 2
604 W 8th St
Kinsley, KS 67547-2329
Phone (620) 659-2732
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016623 | Other | BLUE CROSS BLUE SHIELD | |
| 100009380A | Medicaid | KS |
Other names
- Edwards County Medical Center
- Midway Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdowler@edcomed.com | Direct | |
| Direct Messaging Address | mmawhirter@edcomed.com | Direct |
Other providers in Kinsley, KS
- Deborah Lynette Donavan
- Dallas W Dooley
- Emily Dreiling
- Edwards County Hospital and Healthcare Center
- Edwards County Hospital and Healthcare Center
- Edwards County Hospital and Healthcare Center
- Edwards County Hospital and Healthcare Center
- Edwards County Hospital and Healthcare Center
- Tehren Esparza
- Brad Eric Eustace
All providers in Kinsley, 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 Aug 30, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.