NPIMap

Organization Active NPI

Fillmore County Hospital

  • Critical Access Hospital
  • Geneva, NE
National Provider Identifier
1689769382
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
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 4, 2006
Last updated
Feb 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU 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 3

IdentifierTypeStateIssuer
0134507202MedicaidKS
00047OtherNEBLUE CROSS BLUE SHIELD
H42OtherNEMIDLANDS CHOICE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070115000244 NE Part A Provider - Critical Access Hospital 9638144942 Receives reassigned benefits from 41 practitioners
Practice locations: Geneva, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689769382. Details of each certification follow.

Hospital certification: CCN 281301

Legal name
FILLMORE COUNTY HOSPITAL
Doing business as
FILLMORE COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 1999
Last certification
May 9, 2024
Beds
20
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1900 F St
Geneva, NE 68361-2229
Main/Primary Hospital Location

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Fillmore County HospitalCCN 281301 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Fillmore Co Ambulance2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

NameRoleSinceShare
Christopher M Nichols Individual Corporate OfficerCeo Oct 28, 2021
W-2 Managing EmployeeCeo Aug 16, 2017
Operational/Managerial ControlCeo Aug 16, 2017
Dayle T Harlow Individual W-2 Managing EmployeeCfo Sep 13, 2023
Operational/Managerial ControlCfo Sep 13, 2023
Deborah B Hoarty Individual Corporate Officer Jan 20, 2011
Corporate Director Jul 20, 2006
Tyler Williams Individual Corporate Director Jan 31, 2019
Allan D. Jefferson Individual Corporate Director Jul 28, 2016
Jason L Bespalec Individual Operational/Managerial ControlChief of Staff May 1, 2014
Taylor Kahlandt Individual Corporate Director Jun 28, 2018
Richard Walter Individual 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.

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

Affiliated clinicians 86

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 86

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": "1646006400000",
    "number": "1689769382",
    "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": "NO",
        "enumeration_date": "2006-10-04",
        "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": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134507202",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00047",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "H42",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NE

Sources for this page

Verify at the official NPI Registry.