NPIMap

Organization Active NPI

Hillsboro Hospital LLC

Doing business as Hillsboro Community Hospital

  • Critical Access Hospital
  • Hillsboro, KS
National Provider Identifier
1740828912
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
HILLSBORO HOSPITAL LLC
Doing business as
Hillsboro Community Hospital
Practice address
101 Industrial Rd
Hillsboro, KS 67063-9602
Phone
(620) 947-3114
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Darrel Morris
Title
Coo
Phone
(918) 527-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

101 Industrial Rd
Hillsboro, KS 67063-9602

Mailing address

101 Industrial Rd
Hillsboro, KS 67063-9602
Phone (620) 947-3114

Other names 1

  • Hillsboro Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130001322 KS Part A Provider - Critical Access Hospital 4587090121 Receives reassigned benefits from 24 practitioners
Practice locations: Hillsboro, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740828912. Details of each certification follow.

Hospital certification: CCN 171357

Legal name
HILLSBORO HOSPITAL LLC
Doing business as
HILLSBORO COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 2, 2003
Last certification
Jul 21, 2017
Beds
15
Ownership / control type
Private (for profit)
Most recent change of ownership
Sep 1, 2008 (1 total)
Organization structure
LLCProprietary
Enrollment address
101 Industrial Rd
Hillsboro, KS 67063-9602
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Hillsboro Community HospitalCCN 171357 · All quality measures
Type
Critical Access Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Hillsboro Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

101 Industrial Rd
Ste A
Hillsboro, KS 67063

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Darrel W Morris Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 16.22%
Corporate OfficerChief Operating Officer & Board Mem Dec 9, 2019 16.22%
Corporate DirectorChief Operating Officer & Board Mem Dec 9, 2019 16.22%
Operational/Managerial ControlChief Operating Officer & Board Mem Dec 9, 2019 16.22%
RHG Consolidated LLC Organization, Kansas City, MO LLC, Management services company, For-profit 5% Or Greater Direct Ownership Interest Dec 9, 2019 100%
Operational/Managerial Control Dec 9, 2019 100%
Phyllis Shaffer Individual 5% Or Greater Indirect Ownership Interest Dec 5, 2024 6.08%
Lawrence J Arthur Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 16.67%
Trent M Skaggs Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 16.67%
Corporate OfficerChief Executive Officer Dec 9, 2019 16.67%
Corporate DirectorPresident Dec 9, 2019 16.67%
Operational/Managerial ControlPresident & Board Member Dec 9, 2019 16.67%
LG Medical LLC Organization, Kansas City, MO LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Dec 9, 2019 10%
Brent Lagergren Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 6.09%
Corporate OfficerVP & Chief Compliance Officer Dec 9, 2019 6.09%
Billy W May Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 5.63%
Corporate OfficerVice President Dec 9, 2019 5.63%
Corporate DirectorVice President Dec 9, 2019 5.63%
Dennis L Davis Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 16.67%
Paul Guastello Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 12.97%
Jami Homfeld Individual Corporate OfficerRevenue Cycle Manager Jan 1, 2025 3%

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 23

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 23

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1740828912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 INDUSTRIAL RD",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "670639602",
            "telephone_number": "620-947-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 INDUSTRIAL RD",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "670639602",
            "telephone_number": "620-947-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSBORO HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "DARREL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "918-527-1234"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsboro Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hillsboro, KS

Sources for this page

Verify at the official NPI Registry.