NPIMap

Organization Active NPI

Phillips County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Phillipsburg, KS
National Provider Identifier
1689761892
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H-074-001 Issued in KS
Legal business name
PHILLIPS COUNTY HOSPITAL
Practice address
1150 State St
Phillipsburg, KS 67661-1743
Phone
(785) 543-5226
Fax
(785) 543-6272
NPI assigned
Oct 7, 2006
Last updated
Dec 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Authorized official

Name
Tara Overmiller
Title
Coo
Phone
(785) 540-4925

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H-074-001 KS Primary

Addresses

Primary practice location

1150 State St
Phillipsburg, KS 67661-1743

Mailing address

PO Box 607
Phillipsburg, KS 67661-0607
Phone (785) 543-5226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150313000430 KS Part A Provider - Critical Access Hospital 7012231251 Practice locations: Phillipsburg, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689761892. Details of each certification follow.

Hospital certification: CCN 17Z353

Legal name
PHILLIPS COUNTY HOSPITAL
Doing business as
PHILLIPS COUNTY HEALTH SYSTEMS
Organization structure
GovernmentNon-profit
Enrollment address
1150 State St
Phillipsburg, KS 67661-1743

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
Phillips County Medical C7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Brittani Conrad Individual Corporate DirectorCredentialing Coordinator Jan 1, 2025
W-2 Managing EmployeeCredentialing Coordinator Jan 1, 2025
Mandy Goble Individual Corporate DirectorBilling Manager Jan 1, 2025
W-2 Managing EmployeeBilling Manager Jan 1, 2025
Phillips County Hospital Organization, Phillipsburg, KS Other Apr 1, 2015
Tara Overmiller Individual Corporate OfficerCeo Dec 1, 2022
Corporate DirectorCeo Dec 1, 2022
W-2 Managing EmployeeAd; Dec 1, 2022

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Phillips County Health SystemsPhillipsburg, KS, CCN 171353 Hospital Other Apr 1, 2015
Phillips County Medical ClinicPhillipsburg, KS, CCN 178502 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 3

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": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1689761892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676610607",
            "telephone_number": "785-543-5226",
            "fax_number": "785-543-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 STATE ST",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676611743",
            "telephone_number": "785-543-5226",
            "fax_number": "785-543-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "OVERMILLER",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "785-540-4925"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H-074-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, KS

Sources for this page

Verify at the official NPI Registry.