NPIMap

Organization Active NPI

Mt Grant General Hospital

  • Critical Access Hospital
  • Hawthorne, NV
National Provider Identifier
1801844527
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
651HOS-10 Issued in NV
Legal business name
MT GRANT GENERAL HOSPITAL
Practice address
200 South a Street
Hawthorne, NV 89415-1510
Phone
(775) 945-2461
Fax
(775) 945-2359
NPI assigned
May 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory J Schumann
Title
Business Office Manager
Phone
(775) 945-2461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 651HOS-10 NV Primary

Addresses

Primary practice location

200 South a Street
Hawthorne, NV 89415-1510

Mailing address

200 South a Street
PO Box 1510
Hawthorne, NV 89415-1510
Phone (775) 945-2461

Other identifiers 1

IdentifierTypeStateIssuer
NV6028OtherNVBLUE CROSS - HOSPITAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040312001277 NV Part B Supplier - Clinic/Group Practice 1951290337 Receives reassigned benefits from 34 practitioners
Practice locations: Hawthorne, NV
O20100805000925 NV Part A Provider - Critical Access Hospital 1951290337 Receives reassigned benefits from 11 practitioners
Practice locations: Hawthorne, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801844527. Details of each certification follow.

Hospital certification: CCN 291300

Legal name
MT GRANT GENERAL HOSPITAL
Doing business as
MT GRANT GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2000
Last certification
Sep 23, 2020
Beds
11
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Incorporated
Jun 7, 1984 in NV
Enrollment address
200 South a Street
Hawthorne, NV 89415-1510
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
Mount Grant General HospitalCCN 291300 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Denise Ferguson Individual Corporate OfficerCeo/Administrator Jun 1, 2022 100%
W-2 Managing EmployeeCeo/Administrator Jun 1, 2022 100%
Mt Grant General Hospital Organization, Hawthorne, NV Other Jun 7, 1984 100%
Sandrae J Lehman Individual Corporate OfficerCfo Feb 28, 2020 100%
W-2 Managing EmployeeCfo Feb 28, 2020 100%

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mt Grant General HospitalHawthorne, NV, CCN 29Z300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 1966
Nov 1, 1966
Lefa L Seran SNF Mt GrantHawthorne, NV, CCN 295001 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF		 Nov 1, 1966
Nov 1, 1966
Nov 1, 1966
Mt Grant Medical BuildingHawthorne, NV, CCN 293975 Rural health clinic Other (100%) Jun 7, 1984

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 360

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 360

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801844527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOUTH A STREET",
            "address_2": "PO BOX 1510",
            "city": "HAWTHORNE",
            "state": "NV",
            "postal_code": "894151510",
            "telephone_number": "775-945-2461",
            "fax_number": "775-945-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTH A STREET",
            "city": "HAWTHORNE",
            "state": "NV",
            "postal_code": "894151510",
            "telephone_number": "775-945-2461",
            "fax_number": "775-945-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT GRANT GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHUMANN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "775-945-2461"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NV",
            "license": "651HOS-10",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS - HOSPITAL",
            "identifier": "NV6028",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NV

Sources for this page

Verify at the official NPI Registry.