Active NPI
Fillmore County Hospital
- Medicare Defined Swing Bed Hospital Unit
- Geneva, NE
National Provider Identifier
1689756561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- Legal business name
- FILLMORE COUNTY HOSPITAL
- Practice address
- 1900 F St
Geneva, NE 68361-2229 - Phone
- (402) 759-3167
- Fax
- (402) 759-3505
- NPI assigned
- Oct 19, 2006
- Last updated
- Feb 28, 2022
- Organization subpart
- Yes
- Parent organization
- FILLMORE COUNTY HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Nichols
- Title
- Ceo
- Phone
- (402) 759-3167
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Primary |
Addresses
Primary practice location
1900 F St
Geneva, NE 68361-2229
Mailing address
PO Box 193
Geneva, NE 68361-0193
Phone (402) 759-3167
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H42 | Other | NE | MIDLANDS CHOICE SWING BED |
| 00345 | Other | NE | BCBS SWING BED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091021000831 | NE | Part A Provider - Critical Access Hospital | 9638144942 | Practice locations: Geneva, NE |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1689756561. Details of each certification follow.
Hospital certification: CCN 28Z301
- Legal name
- FILLMORE COUNTY HOSPITAL
- Doing business as
- FILLMORE COUNTY HOSPITAL
- Organization structure
- Other
- Enrollment address
- 1900 F St
Geneva, NE 68361-2229
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Fillmore Co Ambulance
- Part of
- Fillmore Co Ambulance
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Critical Access Hospital
- Geneva, NE
- NPI 1689769382
Ownership & related parties
All disclosed owners & managing parties 8
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Christopher M Nichols | Corporate Officer | Oct 28, 2021 | |
| W-2 Managing Employee | Aug 16, 2017 | ||
| Operational/Managerial Control | Aug 16, 2017 | ||
| Dayle T Harlow | W-2 Managing Employee | Sep 13, 2023 | |
| Operational/Managerial Control | Sep 13, 2023 | ||
| Deborah B Hoarty | Corporate Officer | Jan 20, 2011 | |
| Corporate Director | Jul 20, 2006 | ||
| Tyler Williams | Corporate Director | Jan 31, 2019 | |
| Allan D. Jefferson | Corporate Director | Jul 28, 2016 | |
| Jason L Bespalec | Operational/Managerial Control | May 1, 2014 | |
| Taylor Kahlandt | Corporate Director | Jun 28, 2018 | |
| Richard Walter | Corporate Officer | Jul 28, 2016 | |
| Corporate Director | Jul 7, 2014 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Geneva, NE
- NPI 1447271457
Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646006400000",
"number": "1689756561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 193",
"city": "GENEVA",
"state": "NE",
"postal_code": "683610193",
"telephone_number": "402-759-3167",
"fax_number": "402-759-3505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 F ST",
"city": "GENEVA",
"state": "NE",
"postal_code": "683612229",
"telephone_number": "402-759-3167",
"fax_number": "402-759-3505"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FILLMORE COUNTY HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FILLMORE COUNTY HOSPITAL",
"enumeration_date": "2006-10-19",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A",
"authorized_official_last_name": "NICHOLS",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "402-759-3167"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE SWING BED",
"identifier": "H42",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS SWING BED",
"identifier": "00345",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, NE
- Emilee L. O'Brien Licsw LLC
- Family First Dental Associates of Nebraska, P.C. (Family 1st Dental of Geneva)
- Fillmore County Hospital
- Fillmore County Hospital
- Fillmore County Hospital
- Fillmore County Hospital
- Fillmore County Medical Center P.C.
- Fillmore County School District 30-0025 (Fillmore Central Public School)
- Marirose Fox, PA-C
- Natasha R Frei, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.