NPIMap

Organization Active NPI

Nevada City Hospital

Doing business as Nevada Medical Clinic

  • Rural Health Clinic/Center
  • Nevada, MO
National Provider Identifier
1730805136
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NEVADA CITY HOSPITAL
Doing business as
Nevada Medical Clinic
Practice address
900 S Adams St
Nevada, MO 64772-3210
Phone
(417) 667-6015
Fax
(417) 667-4234
NPI assigned
Oct 17, 2022
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NEVADA CITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

900 S Adams St
Nevada, MO 64772-3210

Mailing address

800 S Ash St
Nevada, MO 64772-3224
Phone (417) 667-3355

Other names 1

  • Nevada Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221108003271 MO Part A Provider - Rural Health Clinic 9830095280 Practice locations: Nevada, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730805136. Details of each certification follow.

Rural health clinic certification: CCN 268793

Legal name
NEVADA CITY HOSPITAL
Doing business as
NEVADA MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 1, 2022
Last certification
Nov 1, 2022
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
900 S Adams St
Nevada, MO 64772-3210
Related CCNs
260061

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Nevada Regional Med Ctr4 organizations share this tax ID, including this one
Part of
Nevada Regional Med Ctr

Other organizations with this tax ID 3

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

Locations

627 S Ash St
Ste B
Nevada, MO 64772
Phone (417) 667-6800

800 S Ash St
Ste 210
Nevada, MO 64772
Phone (417) 448-3603

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 EmployeePatient Financial Services Nov 1, 2022
Brian Leonard Individual Corporate DirectorBoard Member Feb 1, 2025
Jayne Novak Individual Corporate DirectorBoard Member Nov 1, 2022
Holly B Bush Individual Corporate OfficerCoo/Authorized Official Jun 2, 2025
Amanda Swink Individual Corporate DirectorBoard Member Jan 1, 2024
Mike Brown Individual Corporate DirectorBoard Member/Vice Chair Nov 1, 2022
Candice a Moore Individual Corporate DirectorBoard Member Nov 1, 2022
Aimee Meyer Individual Corporate DirectorBoard Member Nov 1, 2022
Cindy Thompson Individual Corporate DirectorBoard Member Nov 1, 2022
Jason W Anglin Individual Corporate OfficerCeo Nov 1, 2022
Seth Barrett Individual Corporate DirectorBoard Member Jan 1, 2023
Geoff Stewart Individual Corporate DirectorBoard Member 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.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nevada Regional Medical CenterNevada, MO, CCN 26S061 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
NRMC Nowcare ClinicNevada, MO, CCN 268645 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Nevada City Hospital

    dba Nevada Regional Medical Center Now Care Clinic

    • Rural Health Clinic/Center
    • Nevada, MO
    • NPI 1427385517

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Nevada City Hospital

    dba Nevada Regional Medical Center

    • Rural Acute Care Hospital
    • Nevada, MO
    • NPI 1942283866

    5% Or Greater Direct Ownership Interest

    CMS ownership

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2022 Change of OwnershipThis provider was the buyer Nevada Medical Clinic L.L.C.CCN 263901, MO, NPI 1104821867

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

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 107

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 107

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1730805136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S ASH ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723224",
            "telephone_number": "417-667-3355",
            "fax_number": "417-448-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S ADAMS ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723210",
            "telephone_number": "417-667-6015",
            "fax_number": "417-667-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA CITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEVADA CITY HOSPITAL",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nevada, MO

Sources for this page

Verify at the official NPI Registry.