NPIMap

Organization Active NPI

Rush County Memorial Hospital

  • Rural Health Clinic/Center
  • La Crosse, KS
National Provider Identifier
1699877050
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H-083-001 Issued in KS
Legal business name
RUSH COUNTY MEMORIAL HOSPITAL
Practice address
801 Locust
Lacrosse, KS 67548-0520
Phone
(785) 222-2545
Fax
(785) 222-2868
NPI assigned
Sep 5, 2006
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Debra R Hovorka
Title
Cfo
Phone
(785) 514-5619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H-083-001 KS Primary

Addresses

Primary practice location

801 Locust
Lacrosse, KS 67548-0520

Mailing address

PO Box 520
801 Locust
La Crosse, KS 67548-0520
Phone (785) 222-2545

Other identifiers 1

IdentifierTypeStateIssuer
30003941880003MedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061212000446 KS Part A Provider - Rural Health Clinic 3476564840 Practice locations: La Crosse, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699877050. Details of each certification follow.

Rural health clinic certification: CCN 178541

Legal name
RUSH COUNTY MEMORIAL HOSPITAL
Doing business as
RUSH COUNTY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 18, 2006
Last certification
Nov 23, 2015
Ownership / control type
Non-profit – church related
Most recent change of ownership
Oct 19, 2006 (1 total)
Organization structure
OtherProprietary
Enrollment address
801 Locust St
La Crosse, KS 67548-9673
Related CCNs
171342

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0700444Rush County Medical Clinic801 Locust, La Crosse, KS 67548Certificate of waiverAug 31, 2026

National Provider Directory

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
Lindsy B Hobbs Individual W-2 Managing Employee Jan 1, 2023 5%
Debra Hovorka Individual W-2 Managing EmployeeCfo Jun 13, 2022 5%
Michael Wayne Cooper Individual Corporate DirectorCeo Feb 28, 2021
W-2 Managing EmployeeCeo Feb 28, 2021
Elizabeth Metcalf Individual Corporate OfficerDon Dec 14, 2020 5%
W-2 Managing EmployeeDon Dec 14, 2020 5%
Rush County Memorial Hospital Organization, La Crosse, KS Non-profit Operational/Managerial Control Jul 1, 2006 100%

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 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1699877050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "address_2": "801 LOCUST",
            "city": "LA CROSSE",
            "state": "KS",
            "postal_code": "675480520",
            "telephone_number": "785-222-2545",
            "fax_number": "785-222-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 LOCUST",
            "city": "LACROSSE",
            "state": "KS",
            "postal_code": "675480520",
            "telephone_number": "785-222-2545",
            "fax_number": "785-222-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "HOVORKA",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "785-514-5619"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": "H-083-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003941880003",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, KS

Sources for this page

Verify at the official NPI Registry.