NPIMap

Organization Active NPI

Greenwood County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Eureka, KS
National Provider Identifier
1801990833
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H037001 Issued in KS
Legal business name
GREENWOOD COUNTY HOSPITAL
Practice address
100 W 16TH St
Eureka, KS 67045-1064
Phone
(620) 583-7451
Fax
(620) 583-6884
NPI assigned
Sep 11, 2006
Last updated
Jun 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Mr. Edward Riley
Title
Administrator/Ceo
Phone
(620) 583-7451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H037001 KS Primary

Addresses

Primary practice location

100 W 16TH St
Eureka, KS 67045-1064

Mailing address

100 W 16TH St
Eureka, KS 67045-1064
Phone (620) 583-7451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000014 KS Part A Provider - Critical Access Hospital 0042129603 Practice locations: Eureka, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801990833. Details of each certification follow.

Hospital certification: CCN 17Z339

Legal name
GREENWOOD COUNTY HOSPITAL
Doing business as
GREENWOOD COUNTY HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Jun 3, 1956 in KS
Enrollment address
100 W 16TH St
Eureka, KS 67045-1064

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Greenwood County Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Member of 1

Organizations this organization is a member of, according to the 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
Sandra K Dickerson Individual Corporate OfficerCeo Aug 1, 2017
W-2 Managing EmployeeCeo Aug 1, 2017
Janel M Palmer Individual W-2 Managing Employee Jan 1, 2014
County of Greenwood Organization, Eureka, KS 5% Or Greater Direct Ownership Interest Aug 19, 2014 100%

Owners & managing parties with NPI records 2

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
Greenwood County Home Health AgencyEureka, KS, CCN 177243 Home health agency Other (100%) Apr 15, 1993

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1801990833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 16TH ST",
            "city": "EUREKA",
            "state": "KS",
            "postal_code": "670451064",
            "telephone_number": "620-583-7451",
            "fax_number": "620-583-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 16TH ST",
            "city": "EUREKA",
            "state": "KS",
            "postal_code": "670451064",
            "telephone_number": "620-583-7451",
            "fax_number": "620-583-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "620-583-7451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H037001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, KS

Sources for this page

Verify at the official NPI Registry.