NPIMap

Organization Active NPI

Satanta District Hospital and Long-Term Care

Doing business as Satanta District Hospital

  • Critical Access Hospital
  • Satanta, KS
National Provider Identifier
1740230549
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H041001 Issued in KS
Legal business name
SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
Doing business as
Satanta District Hospital
Practice address
401 Cheyenne Street
Satanta, KS 67870-0159
Phone
(620) 649-2761
Fax
(620) 649-2776
NPI assigned
May 11, 2006
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Tina Pendergraft
Title
Administrator
Phone
(620) 649-2761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H041001 KS Primary

Addresses

Primary practice location

401 Cheyenne Street
Satanta, KS 67870-0159

Mailing address

PO Box 159
Satanta, KS 67870-0159
Phone (620) 649-2761

Other identifiers 2

IdentifierTypeStateIssuer
000165OtherKSBLUE CROSS PROVIDER NUMBE
100080490AMedicaidKS

Other names 1

  • Satanta District Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061104000194 KS Part A Provider - Critical Access Hospital 5991616054 Receives reassigned benefits from 15 practitioners
Practice locations: Satanta, KS
O20100930018968 KS DME Supplier - PharmacyDME Supplier - Medical Supply CompanyDME Supplier - Hospital 5991616054 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Satanta, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740230549. Details of each certification follow.

Hospital certification: CCN 171324

Legal name
SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
Doing business as
SATANTA DISTRICT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 19, 2000
Last certification
Jan 24, 2019
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
401 Cheyenne
Satanta, KS 67870-8748

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Satanta District Hospital, Clinics, & LtcuCCN 171324 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

401 Cheyenne
#159
Satanta, KS 67870

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
Gaila Ross Individual Corporate OfficerTreasurer Jan 1, 2020
Tina Pendergraft Individual W-2 Managing Employee Sep 25, 2020
Operational/Managerial ControlInterim Ceo Sep 25, 2020
Lee Miller Individual Corporate OfficerVice President Jan 1, 2020
Daniel G Palmgren Individual Corporate OfficerPesident Jan 1, 2020
Satanta District Hospital and Long-Term Care Organization, Satanta, KS Non-profit Operational/Managerial Control Dec 15, 1983
Kevin Wagner Individual Corporate OfficerSecretary Jan 1, 2020
Marceil Cloud Individual Corporate OfficerBoard Member Jan 1, 2020

Owners & managing parties with NPI records 6

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
Satanta District Hospital Clinic SatantaSatanta, KS, CCN 173455 Rural health clinic Operational/Managerial Control Feb 10, 2015
Satanta District Hospital Clinic-SubletteSublette, KS, CCN 173454 Rural health clinic Operational/Managerial Control (100%) Aug 23, 2007

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 15

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 15

Affiliated clinicians 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1740230549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "SATANTA",
            "state": "KS",
            "postal_code": "678700159",
            "telephone_number": "620-649-2761",
            "fax_number": "620-649-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CHEYENNE STREET",
            "city": "SATANTA",
            "state": "KS",
            "postal_code": "678700159",
            "telephone_number": "620-649-2761",
            "fax_number": "620-649-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "PENDERGRAFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-649-2761"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KS",
            "license": "H041001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "000165",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080490A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satanta District Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Satanta, KS

Sources for this page

Verify at the official NPI Registry.