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Organization Active NPI

Excelsior Springs City Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Excelsior Springs, MO
National Provider Identifier
1740387174
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
286-27 Issued in MO
Legal business name
EXCELSIOR SPRINGS CITY HOSPITAL
Practice address
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone
(816) 630-6081
Fax
(816) 629-2707
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Sally S Nance
Title
Ceo
Phone
(816) 629-2739

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 6

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

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

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

Affiliated clinicians 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Hospital certification: CCN 26Z322

Legal name
EXCELSIOR SPRINGS CITY HOSPITAL
Doing business as
EXCELSIOR SPRINGS MEDICAL CENTER
Organization structure
Other · Non-profit
Enrollment address
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Hospital Swing-Bed Unit

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Cameron G Meyer
Individual 		Corporate Officer
Cfo		 Feb 8, 2018
W-2 Managing Employee
Cfo		 Feb 8, 2018
Operational/Managerial Control
Cfo		 Feb 8, 2018
Sarah Gonzalez
Individual 		Corporate Officer Mar 9, 2020
Corporate Director Mar 9, 2020
W-2 Managing Employee Mar 9, 2020
Kristen Dehart
Individual 		Corporate Officer
Ceo		 Jun 6, 2017
Operational/Managerial Control
Ceo		 Jun 6, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070928000557 MO Part a Provider - Critical Access Hospital 7315847209 Receives reassigned benefits from 17 practitioners
Practice locations: Excelsior Springs, MO

National Provider Directory

Tax ID family
Excelsior Springs City Hospital (7 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 286-27 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182

Mailing address

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone (816) 630-6081

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
010421600MedicaidMO

Other names 1

NPPES NPI Registry
  • EXCELSIOR SPRINGS HOSPITAL Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 1, 2011.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1740387174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-630-6081",
            "fax_number": "816-629-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-630-6081",
            "fax_number": "816-629-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR SPRINGS CITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "NANCE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-629-2739"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MO",
            "license": "286-27",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010421600",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXCELSIOR SPRINGS HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Excelsior Springs, MO

Sources for this page

Verify at the official NPI Registry.