NPIMap

Organization Active NPI

Nevada City Hospital

Doing business as Nevada Regional Medical Center Specialty Clinic

  • General Practice Physician
  • Nevada, MO
National Provider Identifier
1689904336
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NEVADA CITY HOSPITAL
Doing business as
Nevada Regional Medical Center Specialty Clinic
Practice address
800 S. Ash Street
Suite 210
Nevada, MO 64772-3223
Phone
(417) 448-3603
Fax
(417) 448-3604
NPI assigned
Dec 31, 2009
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NEVADA CITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Jason Anglin
Title
Ceo/Authorized Official
Phone
(417) 448-3626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

800 S. Ash Street
Suite 210
Nevada, MO 64772-3223

Mailing address

800 S. Ash Street
Nevada, MO 64772-3223
Phone (417) 667-3355

Other names 1

  • Nevada Regional Medical Center Specialty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031208001009 MO Part B Supplier - Clinic/Group Practice 9830095280 Receives reassigned benefits from 111 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nevada, MO
O20071201000130 MO Part A Provider - Hospital 9830095280 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nevada, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689904336. Details of each certification follow.

Hospital certification: CCN 260061

Legal name
NEVADA CITY HOSPITAL
Doing business as
NEVADA REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 1, 2011
Beds
71
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
800 S Ash St
Nevada, MO 64772-3223
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved, Psychiatric unit

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

Other NPIs on the same Medicare enrollment 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Nevada Regional Medical CenterCCN 260061 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Sheldon Family Medical

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3813b615-6514-44ac-92c9-256417b57cd1/

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Michelle Cox Individual W-2 Managing EmployeePFS Manager Jul 5, 2000
Brian Leonard Individual Corporate DirectorBoard Member Feb 1, 2025
Jayne Novak Individual Corporate DirectorBoard Member Jan 1, 2022
Holly B Bush Individual Corporate OfficerCoo/Authorized Official Jun 2, 2025
Amanda Swink Individual Corporate DirectorBoard Member Jan 1, 2025
Mike Brown Individual Corporate DirectorBoard Member Jan 1, 2022
Candice a Moore Individual Corporate DirectorBoard Member Mar 1, 2016
Aimee Meyer Individual Corporate DirectorBoard Member Jan 1, 2022
Cindy Thompson Individual Corporate DirectorBoard Member Jan 1, 2022
Jason W Anglin Individual Corporate OfficerCeo/Authorized Official Nov 21, 2022
Seth Barrett Individual Corporate DirectorBoard Member Jan 1, 2023
Geoff Stewart Individual Corporate Director Jan 1, 2023

Owners & managing parties with NPI records 2

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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 94

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

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1689904336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S. ASH STREET",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723223",
            "telephone_number": "417-667-3355",
            "fax_number": "417-448-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S. ASH STREET",
            "address_2": "SUITE 210",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723223",
            "telephone_number": "417-448-3603",
            "fax_number": "417-448-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA CITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA CITY HOSPITAL",
        "enumeration_date": "2009-12-31",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "ANGLIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "417-448-3626"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Regional Medical Center Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Regional Medical Center Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nevada, MO

Sources for this page

Verify at the official NPI Registry.