NPIMap

Organization Active NPI

Annie Jeffrey Memorial County Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Osceola, NE
National Provider Identifier
1720188139
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
640001 Issued in NE
Legal business name
ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Practice address
531 Beebe St
Osceola, NE 68651-5537
Phone
(402) 747-2031
Fax
(402) 747-1405
NPI assigned
Sep 25, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Joseph W. Lohrman
Title
Ceo/Administrator
Phone
(402) 747-2031

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 640001 NE Primary
Critical Access Hospital 282NC0060X 640001 NE

Addresses

Primary practice location

531 Beebe St
Osceola, NE 68651-5537

Mailing address

PO Box 428
Osceola, NE 68651-0428
Phone (402) 747-2031

Other identifiers 1

IdentifierTypeStateIssuer
00343OtherNEBCBS OF NEBRASKA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000006 NE Part A Provider - Critical Access Hospital 9638088644 Practice locations: Osceola, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720188139. Details of each certification follow.

Hospital certification: CCN 28Z314

Legal name
ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Doing business as
ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Organization structure
OtherNon-profit
Enrollment address
531 Beebe St
Osceola, NE 68651-5537
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Annie Jeffery Mem Co HL3 organizations share this tax ID, including this one
Part of
Annie Jeffery Mem Co HL

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
John R Girard Individual Corporate Officer Jun 3, 1996
Corporate Director Apr 20, 1993
Karen Stevens Individual Corporate Officer Jan 26, 2010
Corporate Director Sep 18, 2007
Allan J Lerch Individual Corporate Director Jul 27, 2021
Cameron L Sidak Individual Contracted Managing EmployeeChief of Staff Jan 27, 2022
Operational/Managerial ControlChief of Staff Jan 27, 2022
Marcus L Augustin Individual Corporate OfficerAdministrator/Ceo Apr 30, 2023
W-2 Managing EmployeeAdministrator/Ceo Apr 30, 2023
Operational/Managerial ControlAdministrator/Ceo Apr 30, 2023
Steven J Peterson Individual Corporate Officer Apr 23, 1991
Corporate Director Apr 23, 1991
Charles a Roberts Individual Corporate Officer Sep 23, 2014
Corporate Director Jan 4, 2011

Owners & managing parties with NPI records 1

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 7

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1720188139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "OSCEOLA",
            "state": "NE",
            "postal_code": "686510428",
            "telephone_number": "402-747-2031",
            "fax_number": "402-747-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 BEEBE ST",
            "city": "OSCEOLA",
            "state": "NE",
            "postal_code": "686515537",
            "telephone_number": "402-747-2031",
            "fax_number": "402-747-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LOHRMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "402-747-2031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "640001",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "640001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "00343",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Osceola, NE

Sources for this page

Verify at the official NPI Registry.