NPIMap

Organization Active NPI

Brown County Hospital

  • Critical Access Hospital
  • Ainsworth, NE
National Provider Identifier
1760464283
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
060001 Issued in NE
Legal business name
BROWN COUNTY HOSPITAL
Practice address
945 E Zero St
Ainsworth, NE 69210-1556
Phone
(402) 387-2800
Fax
(402) 387-2804
NPI assigned
Nov 18, 2005
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Mirya Hallock
Title
Ceo
Phone
(402) 387-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 060001 NE Primary

Addresses

Primary practice location

945 E Zero St
Ainsworth, NE 69210-1556

Mailing address

945 E Zero St
Ainsworth, NE 69210-1556
Phone (402) 387-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000857 NE Part A Provider - Critical Access Hospital 4789593831 Receives reassigned benefits from 9 practitioners
Practice locations: Ainsworth, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760464283. Details of each certification follow.

Hospital certification: CCN 281325

Legal name
BROWN COUNTY HOSPITAL
Doing business as
BROWN COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 1, 2000
Last certification
Jun 27, 2024
Beds
23
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
945 E Zero St
Ainsworth, NE 69210-1556
Other Hospital Practice Location

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
Brown County HospitalCCN 281325 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Brown County Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Brent J Deibler Individual Corporate Officer Jan 18, 2021
Corporate Director Sep 5, 2017
Mirya C Hallock Individual Corporate OfficerCeo May 12, 2022
W-2 Managing EmployeeCeo May 12, 2022
Operational/Managerial ControlCeo May 12, 2022
Theodore R Stearns Individual Corporate OfficerCfo Sep 19, 2022
W-2 Managing EmployeeCfo Dec 19, 2021
Operational/Managerial ControlCfo Dec 19, 2021
Brown County Hospital Organization, Ainsworth, NE Operational/Managerial Control May 1, 2000
Melvin a Campbell Individual W-2 Managing EmployeeChief of Staff Jul 1, 2012
Operational/Managerial ControlChief of Staff Jul 1, 2012

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 2

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

FacilityTypeRoleSince
Brown County HospitalAinsworth, NE, CCN 28Z325 Hospital Operational/Managerial Control May 1, 2000
Ainsworth Family ClinicAinsworth, NE, CCN 288520 Rural health clinic Operational/Managerial Control Jun 1, 2013

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 2

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

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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 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": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1760464283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 E ZERO ST",
            "city": "AINSWORTH",
            "state": "NE",
            "postal_code": "692101556",
            "telephone_number": "402-387-2800",
            "fax_number": "402-387-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E ZERO ST",
            "city": "AINSWORTH",
            "state": "NE",
            "postal_code": "692101556",
            "telephone_number": "402-387-2800",
            "fax_number": "402-387-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "HALLOCK",
        "authorized_official_first_name": "MIRYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-387-2800"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "060001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ainsworth, NE

Sources for this page

Verify at the official NPI Registry.