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Organization Active NPI

Ellsworth County Medical Center

  • Rural Health Clinic/Center
  • Holyrood, KS
National Provider Identifier
1689674657
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ELLSWORTH COUNTY MEDICAL CENTER
Practice address
101 S. Main St.
Holyrood, KS 67450-9642
Phone
(785) 252-3565
Fax
(785) 252-3574
NPI assigned
Jul 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
James Kirkbride
Title
Ceo
Phone
(785) 472-3111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X KS
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

101 S. Main St.
Holyrood, KS 67450-9642

Mailing address

1602 Aylward Ave
Ellsworth, KS 67439-2541
Phone (785) 472-3111

Other identifiers 2

IdentifierTypeStateIssuer
30003930830003MedicaidKS
887OtherKSBCBS

Other names 1

  • ECMC-Rural Health Clinic Holyrood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000647 KS Part A Provider - Rural Health Clinic 5395643357 Practice locations: Holyrood, KS

Rural health clinic certification: CCN 173499

Legal name
ELLSWORTH COUNTY MEDICAL CENTER
Doing business as
ECMC RURAL HEALTH CLINIC HOLYROOD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2001
Last certification
Nov 5, 2013
Ownership / control type
2B
Organization structure
GovernmentNon-profit
Enrollment address
101 S Main St
Holyrood, KS 67450-9688
Related CCNs
171327

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Ellsworth County Medica4 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 5

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

NameRoleSinceShare
Clint Rogers Individual Corporate DirectorVice Chair Jan 1, 2021
Brandy Thornton Individual Corporate DirectorCfo Mar 19, 2024
W-2 Managing EmployeeCfo Mar 19, 2024
James Kirkbride Individual Corporate DirectorCeo Jan 1, 2019
W-2 Managing EmployeeCeo Jan 1, 2019
Karen Pauley Individual Corporate Director Jan 1, 2021
Kenneth L Beneda Individual Corporate DirectorChairman Jan 1, 2021

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ecmc- Rural Health Clinic WilsonWilson, KS, CCN 178500 Rural health clinic Operational/Managerial Control (100%) Jul 29, 2005

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1689674657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S. MAIN ST.",
            "city": "HOLYROOD",
            "state": "KS",
            "postal_code": "674509642",
            "telephone_number": "785-252-3565",
            "fax_number": "785-252-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KIRKBRIDE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-472-3111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003930830003",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "887",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECMC-Rural Health Clinic Holyrood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ECMC-Rural Health Clinic Holyrood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holyrood, KS

Sources for this page

Verify at the official NPI Registry.