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Organization Active NPI

Stanton County Hospital

  • Family Medicine Physician
  • Johnson, KS
National Provider Identifier
1679880363
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
STANTON COUNTY HOSPITAL
Practice address
404 N Chestnut St
Johnson, KS 67855-0639
Phone
(620) 492-1400
Fax
(620) 492-1608
NPI assigned
Sep 2, 2010
Organization subpart
Yes
Parent organization
STANTON COUNTY HOSPITALAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Camille Davidson
Title
Ceo
Phone
(620) 492-6250

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

Practitioners 8

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Rural health clinic certification: CCN 178572

Legal name
STANTON COUNTY HOSPITAL
Doing business as
STANTON COUNTY FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 20, 2012
Last certification
Aug 20, 2012
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
404 N Chestnut St
Johnson, KS 67855-5001
Related CCNs
171343

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928001306 KS Part B Supplier - Clinic/Group Practice 7315939915 Receives reassigned benefits from 11 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Johnson, KS
O20120327000945 KS Part a Provider - Rural Health Clinic 7315939915 Practice locations: Johnson, KS

All disclosed owners & managing parties 4

Medicare enrollment files

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

NameRoleSinceShare
Julie E Edmisson Individual Corporate DirectorBoard Member Jan 1, 1997
Rhonda Wild Individual W-2 Managing EmployeeBusiness Office Manager Jan 1, 2016
County of Stanton Organization, Johnson City, KS 5% Or Greater Direct Ownership Interest Jul 1, 1966 100%
James D Tusten Individual W-2 Managing EmployeeCeo Nov 15, 2011

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stanton County HospitalJohnson, KS, CCN 17Z343 Hospital Other (100%) Feb 20, 2007

National Provider Directory

National Provider Directory
Part of
Stanton County Hosp Lab

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

404 N Chestnut St
Johnson, KS 67855-0639

Mailing address

PO Box 639
Johnson, KS 67855-0639
Phone (620) 492-1400

Other names 1

NPPES NPI Registry
  • STANTON COUNTY FAMILY PRACTICE Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2026.

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1679880363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550639",
            "telephone_number": "620-492-1400",
            "fax_number": "620-492-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N CHESTNUT ST",
            "city": "JOHNSON",
            "state": "KS",
            "postal_code": "678550639",
            "telephone_number": "620-492-1400",
            "fax_number": "620-492-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANTON COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STANTON COUNTY HOSPITAL",
        "enumeration_date": "2010-09-02",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-492-6250"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STANTON COUNTY FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson, KS

Sources for this page

Verify at the official NPI Registry.