NPIMap

Organization Active NPI

Wilson County Hospital

Doing business as Wilson Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Neodesha, KS
National Provider Identifier
1760407407
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H103002 Issued in KS
Legal business name
WILSON COUNTY HOSPITAL
Doing business as
Wilson Medical Center
Practice address
2600 Ottawa Rd
Neodesha, KS 66757-1897
Phone
(620) 325-2611
Fax
(620) 325-8453
NPI assigned
Jul 13, 2006
Last updated
Sep 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Lori C Smith
Title
Cfo
Phone
(620) 325-8388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H103002 KS Primary

Addresses

Primary practice location

2600 Ottawa Rd
Neodesha, KS 66757-1897

Mailing address

2600 Ottawa Rd
P O Box 360
Neodesha, KS 66757-1897
Phone (620) 325-2611

Other names 1

  • Wilson Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070221000256 KS Part A Provider - Critical Access Hospital 0042273971 Receives reassigned benefits from 5 practitioners
Practice locations: Neodesha, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760407407. Details of each certification follow.

Hospital certification: CCN 17Z344

Legal name
WILSON COUNTY HOSPITAL
Doing business as
WILSON MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
2600 Ottawa Rd
Box 360
Neodesha, KS 66757-0360

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).

National Provider Directory

National Provider Directory
Tax ID family
Wilson County Hospital3 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • County of Wilson

    dba Wilson County Health Department

    • Public Health or Welfare Agency
    • Fredonia, KS
    • NPI 1477506434

    Member Of

    NPD member

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
Bryan J Hargis Individual W-2 Managing EmployeeCeo May 27, 2022
WM C Estes Individual Corporate DirectorBoard Member Jun 20, 2013
Drew Johnson Individual Corporate DirectorBoard Member Feb 20, 2014
County of Wilson Organization, Fredonia, KS 5% Or Greater Direct Ownership Interest Mar 1, 2002 100%
Lori C Smith Individual W-2 Managing EmployeeCfo May 27, 2022
Carolyn M Caven Individual W-2 Managing EmployeePFS Director May 27, 2022
Amy Brown Individual Corporate DirectorBoard Member Apr 12, 2006
Bert Chronister Individual Corporate DirectorBoard Member Apr 12, 2006
Justin Newland Individual Corporate DirectorBoard Member May 27, 2022
Julie Lair Individual Corporate DirectorBoard Member Nov 10, 2011
Michael Springer Individual Corporate DirectorBoard Member May 27, 2022

Owners & managing parties with NPI records 1

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

  • County of Wilson

    dba Wilson County Health Department

    • Public Health or Welfare Agency
    • Fredonia, KS
    • NPI 1477506434

    5% Or Greater Direct Ownership Interest

    CMS ownership

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Independence Family MedicineIndependence, KS, CCN 178582 Rural health clinic Operational/Managerial Control May 20, 2013
Neodesha Family MedicineNeodesha, KS, CCN 178610 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017

Owned or controlled facilities with NPI records 2

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 5

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.

Affiliated clinicians 4

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1760407407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 OTTAWA RD",
            "address_2": "P O BOX 360",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667571897",
            "telephone_number": "620-325-2611",
            "fax_number": "620-325-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 OTTAWA RD",
            "city": "NEODESHA",
            "state": "KS",
            "postal_code": "667571897",
            "telephone_number": "620-325-2611",
            "fax_number": "620-325-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-325-8388"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H103002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wilson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neodesha, KS

Sources for this page

Verify at the official NPI Registry.