NPIMap

Organization Active NPI

Washington County Hospital

  • Rural Health Clinic/Center
  • Washington, KS
National Provider Identifier
1790172377
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WASHINGTON COUNTY HOSPITAL
Practice address
302 E 2ND St
Washington, KS 66968-2029
Phone
(785) 325-2211
Fax
(785) 325-3224
NPI assigned
Apr 21, 2015
Last updated
Jul 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Roxanne Schottel
Title
Ceo
Phone
(785) 325-2211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X H101-002 KS
Rural Health Clinic/Center 261QR1300X KS Primary

Addresses

Primary practice location

302 E 2ND St
Washington, KS 66968-2029

Mailing address

304 E 3Rd St
Washington, KS 66968-2033
Phone (785) 325-2211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151008001941 KS Part A Provider - Rural Health Clinic 6901844208 Practice locations: Washington, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790172377. Details of each certification follow.

Rural health clinic certification: CCN 178594

Legal name
WASHINGTON COUNTY HOSPITAL
Doing business as
FAMILY MEDICINE OF WASHINGTON COUNTY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 17, 2016
Last certification
Feb 8, 2019
Ownership / control type
Non-profit – church related
Organization structure
GovernmentProprietary
Enrollment address
302 E 2ND St
Washington, KS 66968-2029
Related CCNs
171351

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).

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
17D2100531Family Medicine of Washington County302 East 2ND Street, Washington, KS 66968Certificate of waiverAug 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Washington Medical Clinic2 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 6

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

NameRoleSinceShare
Justin Dragastin Individual Corporate Director Jan 1, 2016
Ronald Nutz Individual Corporate Director Jan 1, 2018
Rebecca L Holsch Individual Corporate Director Apr 1, 2011
Cynthia Ohlde Individual Corporate Director Jan 1, 2017
Roxanne Schottel Individual Corporate OfficerCeo Mar 1, 2016
W-2 Managing EmployeeCeo Mar 1, 2016
Larry D Stoppel Individual Corporate Director Jan 1, 2015

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Washington County HospitalWashington, KS, CCN 171351 Hospital Operational/Managerial Control Jul 6, 2010

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1790172377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E 3RD ST",
            "city": "WASHINGTON",
            "state": "KS",
            "postal_code": "669682033",
            "telephone_number": "785-325-2211",
            "fax_number": "785-325-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E 2ND ST",
            "city": "WASHINGTON",
            "state": "KS",
            "postal_code": "669682029",
            "telephone_number": "785-325-2211",
            "fax_number": "785-325-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "SCHOTTEL",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-325-2211"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "KS",
            "license": "H101-002",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, KS

Sources for this page

Verify at the official NPI Registry.