NPIMap

Organization Active NPI

Johnson County Hospital

Doing business as JCH Professional Services

  • Family Medicine Physician
  • Tecumseh, NE
National Provider Identifier
1780895110
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHNSON COUNTY HOSPITAL
Doing business as
JCH Professional Services
Practice address
202 High Street
Tecumseh, NE 68450
Phone
(402) 335-3361
Fax
(402) 335-6342
NPI assigned
May 25, 2007
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNSON COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Mary Jane Kent
Title
Ceo
Phone
(402) 335-3361

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

202 High Street
Tecumseh, NE 68450

Mailing address

PO Box 538
Tecumseh, NE 68450-0538
Phone (402) 335-2811

Other identifiers 2

IdentifierTypeStateIssuer
10025541800MedicaidNE
10025542100MedicaidNE

Other names 1

  • JCH Professional Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JohnsonCountyHospital@jchosp.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000738 NE Part B Supplier - Clinic/Group Practice 4688583644 Receives reassigned benefits from 43 practitioners
Practice locations: Tecumseh, NE

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Part of
Johnson County Hospital

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Johnson County Hospital Home Health ServicesTecumseh, NE, CCN 287073 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1980

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1780895110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "684500538",
            "telephone_number": "402-335-2811",
            "fax_number": "402-335-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HIGH STREET",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "68450",
            "telephone_number": "402-335-3361",
            "fax_number": "402-335-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNSON COUNTY HOSPITAL",
        "enumeration_date": "2007-05-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-335-3361"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025541800",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025542100",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JohnsonCountyHospital@jchosp.cernerdirect.com",
            "affiliation": "N",
            "address_1": "202 High Street",
            "city": "Tecumseh",
            "state": "NE",
            "country_code": "US",
            "postal_code": "68450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JCH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tecumseh, NE

Sources for this page

Verify at the official NPI Registry.