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Brown County Hospital

Organization Active NPI Critical Access Hospital · Ainsworth, NE

NPI 1760464283 · NPPES record last updated Aug 15, 2022

Key facts

NPI
1760464283
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
060001 (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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 2

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

Other NPIs with the same Medicare PAC ID 3

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

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.

Corporate family (same tax ID) 1

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

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

Facilities with the same owner 2

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

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 27

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

View all 27

Medicare Care Compare: Hospital

Listed as
Brown County Hospital CCN 281325
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

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
Other · Non-profit
Enrollment address
945 E Zero St
Ainsworth, NE 69210-1556
Other Hospital Practice Location

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 Officer
Ceo		 May 12, 2022
W-2 Managing Employee
Ceo		 May 12, 2022
Operational/Managerial Control
Ceo		 May 12, 2022
Theodore R Stearns
Individual 		Corporate Officer
Cfo		 Sep 19, 2022
W-2 Managing Employee
Cfo		 Dec 19, 2021
Operational/Managerial Control
Cfo		 Dec 19, 2021
Brown County Hospital
Organization · Ainsworth, NE 		Operational/Managerial Control May 1, 2000
Melvin a Campbell
Individual 		W-2 Managing Employee
Chief of Staff		 Jul 1, 2012
Operational/Managerial Control
Chief of Staff		 Jul 1, 2012

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 Hospital
Ainsworth, NE · CCN 28Z325		 Hospital Operational/Managerial Control May 1, 2000
Ainsworth Family Clinic
Ainsworth, NE · CCN 288520		 Rural health clinic Operational/Managerial Control Jun 1, 2013

Medicare enrollment records

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

National Provider Directory

Tax ID family
Brown County Hospital (2 organizations share this tax ID)

Specialties & licenses

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

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

Other identifiers

IdentifierTypeStateIssuer
0136OtherNEBCBS
006895400OtherFEDERAL BLACK LUNG PROGRA

Other providers in Ainsworth, NE

All providers in Ainsworth, NE · Critical Access Hospital in Nebraska

Sources for this page

Verify at the official NPI Registry.