NPIMap

Organization Active NPI

Boone County Health Center

Doing business as Newman Grove Medical Clinic

  • Rural Health Clinic/Center
  • Newman Grove, NE
National Provider Identifier
1750778940
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BOONE COUNTY HEALTH CENTER
Doing business as
Newman Grove Medical Clinic
Practice address
108 N 1St St
Newman Grove, NE 68758
Phone
(402) 447-6214
NPI assigned
Apr 25, 2015
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BOONE COUNTY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Caleb K Poore
Title
Ceo
Phone
(402) 395-3213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

108 N 1St St
Newman Grove, NE 68758

Mailing address

PO Box 151
Albion, NE 68620-0151
Phone (402) 395-2191

Other names 1

  • Newman Grove Medical Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BCHCHOSPITAL@boonecohealth.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160412001688 NE Part A Provider - Rural Health Clinic 1254306178 Practice locations: Newman Grove, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750778940. Details of each certification follow.

Rural health clinic certification: CCN 288542

Legal name
BOONE COUNTY HEALTH CENTER
Doing business as
NEWMAN GROVE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 17, 2016
Last certification
Jan 7, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
108 N 1St St
Newman Grove, NE 68758-6013
Related CCNs
281334

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

Other NPIs with the same Medicare PAC ID 8

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0455621Newman Grove Medical Clinic108 N 1St Street, Newman Grove, NE 68758ComplianceSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Laboratory Services11 organizations share this tax ID, including this one
Part of
Laboratory Services

Other organizations with this tax ID 10

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

Locations

1173 S 8th St
Albion, NE 68620
Phone (402) 395-5013

723 W Fairview St
Albion, NE 68620
Phone (402) 385-3149

104 N 1st St
Newman Grove, NE 68758
Phone (402) 447-6214

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Tony Kurtenbach Individual Corporate Director Jul 1, 2019
Dana J Cox Individual Corporate Officer Aug 2, 2024
Corporate Director Jul 1, 2024
Caleb Poore Individual Corporate OfficerCeo Oct 16, 2023
W-2 Managing EmployeeCeo Oct 16, 2023
Operational/Managerial ControlCeo Oct 16, 2023
Kim Beierman Individual Corporate Officer Oct 26, 2021
Corporate Director Jul 1, 2015
Paul Groeteke Individual Corporate Officer Oct 25, 2016
Corporate Director Jul 1, 2015
Gary Stokes Individual Corporate Director Jul 1, 2025
John F Mazour Individual W-2 Managing EmployeeMD; Sep 1, 2018
Operational/Managerial ControlMedical Director Sep 1, 2018
Kristie L Stricklin Individual W-2 Managing EmployeeAd;VP of Clinic Services Jul 12, 2019
Operational/Managerial ControlVP of Clinic Services Jul 12, 2019
Rita a Liss Individual W-2 Managing EmployeeCfo Jul 1, 2017
Operational/Managerial ControlCfo Jul 1, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1750778940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "ALBION",
            "state": "NE",
            "postal_code": "686200151",
            "telephone_number": "402-395-2191",
            "fax_number": "402-395-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N 1ST ST",
            "city": "NEWMAN GROVE",
            "state": "NE",
            "postal_code": "68758",
            "telephone_number": "402-447-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE COUNTY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOONE COUNTY HEALTH CENTER",
        "enumeration_date": "2015-04-25",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "POORE",
        "authorized_official_first_name": "CALEB",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-395-3213"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BCHCHOSPITAL@boonecohealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "723 W Fairview St",
            "city": "Albion",
            "state": "NE",
            "country_code": "US",
            "postal_code": "686201725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Newman Grove Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newman Grove Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newman Grove, NE

Sources for this page

Verify at the official NPI Registry.