NPIMap

Organization Active NPI

Ashland District Hospital

Doing business as Ashland Health Center-Clinic

  • Rural Health Clinic/Center
  • Ashland, KS
National Provider Identifier
1659466357
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ASHLAND DISTRICT HOSPITAL
Doing business as
Ashland Health Center-Clinic
Practice address
625 Kentucky St
Ashland, KS 67831-3199
Phone
(620) 635-2222
Fax
(620) 635-4481
NPI assigned
Oct 4, 2006
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Sandrea D Wright
Title
Cfo
Phone
(620) 635-2241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X KS Primary

Addresses

Primary practice location

625 Kentucky St
Ashland, KS 67831-3199

Mailing address

PO Box 188
Ashland, KS 67831-0188
Phone (620) 635-2241

Other identifiers 1

IdentifierTypeStateIssuer
100098770CMedicaidKS

Other names 1

  • ASHLAND HEALTH CENTER-CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050224001015 KS Part A Provider - Rural Health Clinic 6800849324 Practice locations: Ashland, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659466357. Details of each certification follow.

Rural health clinic certification: CCN 173476

Legal name
ASHLAND DISTRICT HOSPITAL
Doing business as
ASHLAND HEALTH CENTER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 11, 1998
Last certification
Dec 4, 2013
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
625 S Kentucky
Box 188
Ashland, KS 67831-3199
Related CCNs
171304

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).

National Provider Directory

National Provider Directory
Tax ID family
Ashland Dist Hosp PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Sandra Moore Individual Corporate OfficerCfo Feb 16, 2020
W-2 Managing EmployeeCfo Feb 16, 2020
Jessie Luckie Individual Corporate Officer Jan 1, 2018
Kim Hazen Individual Corporate Officer May 1, 2015
Jannica Null Individual Corporate Officer Jan 1, 2018
Chance Wilkinson Individual Corporate Officer Jan 1, 2022
Sandrea D Wright Individual Corporate Officer Feb 16, 2020
W-2 Managing EmployeeCeo Jul 5, 2016

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1659466357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "ASHLAND",
            "state": "KS",
            "postal_code": "678310188",
            "telephone_number": "620-635-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENTUCKY ST",
            "city": "ASHLAND",
            "state": "KS",
            "postal_code": "678313199",
            "telephone_number": "620-635-2222",
            "fax_number": "620-635-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLAND DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "SANDREA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-635-2241"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098770C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASHLAND HEALTH CENTER-CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ASHLAND HEALTH CENTER-CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KS

Sources for this page

Verify at the official NPI Registry.