NPIMap

Organization Active NPI

Excelsior Springs City Hospital

Doing business as Excelsior Springs 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
Doing business as
Excelsior Springs Hospital
Practice address
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone
(816) 630-6081
Fax
(816) 629-2707
NPI assigned
Sep 20, 2006
Last updated
Sep 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

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

Specialties & licenses 1

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

Addresses

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 names 1

  • EXCELSIOR SPRINGS HOSPITAL Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740387174. Details of each certification follow.

Hospital certification: CCN 26Z322

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

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Kenton G Kaufman MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

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 OfficerCfo Feb 8, 2018
W-2 Managing EmployeeCfo Feb 8, 2018
Operational/Managerial ControlCfo 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 OfficerCeo Jun 6, 2017
Operational/Managerial ControlCeo Jun 6, 2017

Practitioners & affiliated clinicians

Practitioners 18

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 18

Affiliated clinicians 3

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": "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": [],
    "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.