NPIMap

Organization Active NPI

Columbus Community Hospital Inc

Doing business as Hospice of Columbus Community Hospital

  • Community Based Hospice Care Agency
  • Columbus, NE
National Provider Identifier
1730283771
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOSPICE 5 Issued in NE
Legal business name
COLUMBUS COMMUNITY HOSPITAL INC
Doing business as
Hospice of Columbus Community Hospital
Practice address
3005 19TH St
Suite 600
Columbus, NE 68601-4248
Phone
(402) 562-3300
Fax
(402) 562-4613
NPI assigned
Sep 11, 2006
Last updated
May 15, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBUS COMMUNITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

Name
Mr. Chad E Van Cleave
Title
Vice-President Finance
Phone
(402) 564-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOSPICE 5 NE Primary

Addresses

Primary practice location

3005 19TH St
Suite 600
Columbus, NE 68601-4248

Mailing address

PO Box 1800
Columbus, NE 68602-1800
Phone (402) 564-7118

Other identifiers 2

IdentifierTypeStateIssuer
10025140700MedicaidNE
00500OtherNEBCBS NE HOSPICE

Other names 1

  • Hospice of Columbus Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070915000245 NE Part A Provider - Hospice 7517954944 Practice locations: Columbus, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730283771. Details of each certification follow.

Hospice certification: CCN 281524

Legal name
COLUMBUS COMMUNITY HOSPITAL INC
Doing business as
HOSPICE OF COLUMBUS COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 1, 1996
Last certification
Jan 17, 2020
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Sep 13, 1971 in NE
Enrollment address
3005 19TH St
Ste 600
Columbus, NE 68601-4248

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Columbus Community HospitalCCN 281524 · All quality measures
Ownership
Non-Profit
Certified
Aug 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
South Sioux City Medica6 organizations share this tax ID, including this one
Part of
South Sioux City Medica

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Charles Seadschlag Individual Corporate Director May 1, 2021
John Pavlik Individual Corporate Officer May 1, 2023
Corporate Director May 2, 2022
Tanya Sandifer Individual W-2 Managing EmployeeVP of Patient Care Services Jul 31, 2023
Operational/Managerial ControlVP of Patient Care Services Jul 31, 2023
Craig Matthew Pekny Individual Corporate Director May 2, 2022
Michael Thomas Hansen Individual Corporate OfficerBoard Secretary & President/Ceo Nov 30, 2009
W-2 Managing EmployeeBoard Secretary & President/Ceo Nov 30, 2009
Operational/Managerial ControlBoard Secretary & President/Ceo Nov 30, 2009
Keith Luedders Individual W-2 Managing EmployeeVice President Ancillary Services Aug 3, 2020
Operational/Managerial ControlVice President Ancillary Services Aug 3, 2020
Daniel J Rosenquist Individual Corporate Director May 1, 2019
Mark Steven Howerter Individual W-2 Managing EmployeeChief Medical Officer Jul 30, 2023
Operational/Managerial ControlChief Medical Officer Jul 30, 2023
Jody M Willison Individual W-2 Managing EmployeeHospice Director Jul 1, 2014
Operational/Managerial ControlHospice Director Jul 1, 2014
Jeffery L Gokie Individual Corporate Director May 1, 2016
Joseph L Citta Individual Corporate Director Oct 1, 2022
Julie a Haney Individual Corporate Officer May 1, 2019
Corporate Director May 1, 2016
Abbie M Tessendorf Individual Corporate Director May 1, 2020
Scott E Messersmith Individual W-2 Managing EmployeeVice President of Operations and HR May 9, 2016
Operational/Managerial ControlVice President of Operations and HR May 9, 2016
Rolando S Renteria Individual Corporate Director May 1, 2023
Chad E Vancleave Individual Corporate OfficerVice-President Finance Apr 5, 2015
W-2 Managing EmployeeVice-President Finance Oct 19, 2009
Operational/Managerial ControlVice-President Finance Oct 19, 2009
Jacqueline Tessendorf Individual Corporate Director May 1, 2023
Sarah S Pillen Individual Corporate Officer May 1, 2021
Corporate Director May 1, 2018
Dale a Zaruba Individual Contracted Managing EmployeeHospice Medical Director Aug 1, 2010
Operational/Managerial ControlHospice Medical Director Aug 1, 2010

Owners & managing parties with NPI records 4

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

Affiliated clinicians 12

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1730283771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1800",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686021800",
            "telephone_number": "402-564-7118",
            "fax_number": "402-562-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 19TH ST",
            "address_2": "SUITE 600",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "686014248",
            "telephone_number": "402-562-3300",
            "fax_number": "402-562-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBUS COMMUNITY HOSPITAL INC",
        "enumeration_date": "2006-09-11",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "VAN CLEAVE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE-PRESIDENT FINANCE",
        "authorized_official_telephone_number": "402-564-7118",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE 5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025140700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE HOSPICE",
            "identifier": "00500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Columbus Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, NE

Sources for this page

Verify at the official NPI Registry.