NPIMap

Organization Active NPI

Minneola District Hospital NBR 2

Doing business as Minneola Community Clinic

  • Rural Health Clinic/Center
  • Minneola, KS
National Provider Identifier
1811086093
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H013002 Issued in KS
Legal business name
MINNEOLA DISTRICT HOSPITAL NBR 2
Doing business as
Minneola Community Clinic
Practice address
222 Main St
Minneola, KS 67865-8511
Phone
(620) 885-4202
Fax
(620) 885-4805
NPI assigned
Oct 12, 2006
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MINNEOLA DISTRICT HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Deborah Bruner
Title
Ceo
Phone
(620) 885-4264

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H013002 KS Primary
Family Medicine Physician 207Q00000X H013002 KS

Addresses

Primary practice location

222 Main St
Minneola, KS 67865-8511

Mailing address

PO Box 127
Minneola, KS 67865-0127
Phone (620) 885-4202

Other identifiers 3

IdentifierTypeStateIssuer
100010520HMedicaidKS
110485OtherBLUE SHIELD
000422OtherKSBLUE CROSS RHC

Other names 1

  • Minneola Community Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050302000745 KS Part B Supplier - Clinic/Group Practice 1355252545 Receives reassigned benefits from 61 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dodge City, KS; Minneola, KS; Fowler, KS
O20051221000455 KS Part A Provider - Rural Health Clinic 1355252545 Practice locations: Minneola, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811086093. Details of each certification follow.

Rural health clinic certification: CCN 178535

Legal name
MINNEOLA DISTRICT HOSPITAL NBR 2
Doing business as
MINNEOLA COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 1, 2006
Last certification
Nov 8, 2010
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
222 Main St
Minneola, KS 67865-8511
Related CCNs
171368

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).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
17D0453241Minneola Community Clinic222 Main, Minneola, KS 67865Certificate of waiverMay 10, 2028

National Provider Directory

National Provider Directory
Part of
Minneola Dist Hosp

Locations

14001 N 7th St
Ste F111
Phoenix, AZ 85022
Phone (602) 633-3780

212 Main St
Minneola, KS 67865
Phone (620) 885-4202

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
Dianna Beebe Individual Corporate Director Apr 5, 2011
Deborah a Bruner Individual Corporate DirectorCeo/Administrator Oct 25, 2012
W-2 Managing EmployeeCeo/Administrator Oct 25, 2012
Jennifer Denison Individual Corporate Director Apr 5, 2011

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Minneola District HospitalMinneola, KS, CCN 171368 Hospital Other (100%) Jun 24, 2015

Owned or controlled facilities with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1811086093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "MINNEOLA",
            "state": "KS",
            "postal_code": "678650127",
            "telephone_number": "620-885-4202",
            "fax_number": "620-885-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "city": "MINNEOLA",
            "state": "KS",
            "postal_code": "678658511",
            "telephone_number": "620-885-4202",
            "fax_number": "620-885-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNEOLA DISTRICT HOSPITAL NBR 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNEOLA DISTRICT HOSPITAL",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "BRUNER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-885-4264"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": "H013002",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "H013002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100010520H",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "110485",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RHC",
            "identifier": "000422",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minneola Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Minneola Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneola, KS

Sources for this page

Verify at the official NPI Registry.