NPIMap

Organization Active NPI

Humboldt General Hospital

  • Critical Access Hospital
  • Winnemucca, NV
National Provider Identifier
1750498010
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
645HOS-11 Issued in NV
Legal business name
HUMBOLDT GENERAL HOSPITAL
Practice address
118 E Haskell St
Winnemucca, NV 89445-3247
Phone
(775) 623-5222
Fax
(775) 623-5904
NPI assigned
Aug 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mrs. Robyn Dunckhorst, RN
Title
Administrator
Phone
(775) 623-5222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 645HOS-11 NV Primary

Addresses

Primary practice location

118 E Haskell St
Winnemucca, NV 89445-3247

Mailing address

118 E Haskell St
Winnemucca, NV 89445-3247
Phone (775) 623-5222

Other identifiers 2

IdentifierTypeStateIssuer
001207855MedicaidNV
100510385MedicaidNV

Other names 1

  • Humboldt County Hospital District Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd2.ssigroup.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other The SSI Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040614000195 NV Part B Supplier - Clinic/Group Practice 5193709798 Receives reassigned benefits from 49 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winnemucca, NV
O20061104000361 NV Part A Provider - Critical Access Hospital 5193709798 Receives reassigned benefits from 83 practitioners
Practice locations: Winnemucca, NV
O20160128002074 NV Part A Provider - Critical Access Hospital 5193709798 Receives reassigned benefits from 10 practitioners
Practice locations: Winnemucca, NV

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1750498010. Details of each certification follow.

Hospital certification: CCN 291308

Legal name
HUMBOLDT GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 2005
Last certification
Nov 4, 2021
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1985
Enrollment address
118 E Haskell St
Winnemucca, NV 89445-3247
Other Hospital Practice Location

Hospital certification: CCN 29Z308

Legal name
HUMBOLDT GENERAL HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Jul 1, 1985 in NV
Enrollment address
118 E Haskell St
Winnemucca, NV 89445-3247
Other Hospital Practice Location

Other NPIs with the same Medicare PAC ID 4

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
Humboldt General HospitalCCN 291308 · All quality measures
Overall star rating
2 of 5
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

4721 Morrison Dr
Ste 100
Mobile, AL 36609

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kimberley Anne Plummer Individual Corporate OfficerCfo Jul 1, 2021
W-2 Managing EmployeeCfo Jul 1, 2021
Corporate OfficerCfo Oct 1, 2021
W-2 Managing EmployeeCfo Oct 1, 2018
Humboldt General Hospital Organization, Winnemucca, NV Other Mar 12, 1985 100%
5% Or Greater Direct Ownership Interest Mar 24, 2005 100%
Robyn Ann Dunckhorst Individual Corporate OfficerCeo Oct 1, 2021
W-2 Managing EmployeeCeo Oct 1, 2021
Corporate OfficerCeo Jan 8, 2021
W-2 Managing EmployeeCeo Jan 8, 2021
Kelly C Pullin Individual W-2 Managing Employee Aug 31, 2020
W-2 Managing EmployeeBom Aug 31, 2020

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Humboldt General HospitalWinnemucca, NV, CCN 295024 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1985

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 83

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 83

Affiliated clinicians 152

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

View all 152

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1750498010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "775-623-5222",
            "fax_number": "775-623-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "775-623-5222",
            "fax_number": "775-623-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DUNCKHORST",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-623-5222",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NV",
            "license": "645HOS-11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001207855",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510385",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd2.ssigroup.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "affiliationName": "The SSI Group, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "4721 Morrison Dr Ste 100",
            "city": "Mobile",
            "state": "AL",
            "country_code": "US",
            "postal_code": "366093350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Humboldt County Hospital District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winnemucca, NV

Sources for this page

Verify at the official NPI Registry.