Hodgeman County Health Center
Organization Active NPI Critical Access Hospital · Jetmore, KS
NPI 1821098252 · NPPES record last updated Jul 22, 2009
Key facts
- NPI
- 1821098252
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- HO42001 (KS)
- Legal business name
- HODGEMAN COUNTY HEALTH CENTER
- Practice address
- 809 W. Bramley Street
# 310
Jetmore, KS 67854-9320 - Phone
- (620) 357-8361
- Fax
- (620) 357-6120
- NPI assigned
- Jul 28, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Stacey Briggs
- Title
- Office Manager (Cfo)
- Phone
- (620) 357-8361
Owners & managing parties with NPI records 2
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 2
Practitioners 22
-
Danny Douglas Briggs Jr., PHYSICIAN ASSISTANT
-
Cobra Chamblee, DO
-
James M Clements, APRN
-
Thuy Nguyen, APRN
-
Cooper L Nickel, M.D.
-
Jose Luis Renteria, ACNP
-
Kathy Lenay Wyer, NP-C
-
Hayley Noel Zink, APRN
-
Joshua M White, MD
-
Dusty Atterbury, PA
-
Brooke Rachelle Briggs, APRN
-
Brenda Kay Dinges, APRN FNP-C
-
Michael Lee Goode, CRNA
-
James W Moffitt, MD
-
Naveen Penmasta, MD
-
Samir Shaath, M.D.
-
Robert E Wray, DO
-
Trent Colin Blackwill, CRNA, DNAP
-
Janelle R Harding, APRN
Affiliated clinicians 20
-
Dusty Atterbury, PA
-
Danny Douglas Briggs Jr., PHYSICIAN ASSISTANT
-
Cobra Chamblee, DO
-
James M Clements, APRN
-
Luis E Espinoza, MD
-
Jordyn Mychelle Flores, APRN
-
Michael Lee Goode, CRNA
-
Edmond Habash, P.A-C
-
Roxanne N McGinn, MD
-
Thuy Nguyen, APRN
-
Cooper L Nickel, M.D.
-
Jose Luis Renteria, ACNP
-
Alok Shah, MD
-
Eva Vachal, MD
-
Kathy Lenay Wyer, NP-C
-
Hayley Noel Zink, APRN
-
Joshua M White, MD
Medicare Care Compare: Hospital
- Listed as
- Hodgeman County Health Center
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Hospital certification: CCN 171369
- Legal name
- HODGEMAN COUNTY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- May 1, 2004
- Last certification
- Mar 28, 2016
- Beds
- 16
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Enrollment address
- 809 W Bramley St
Jetmore, KS 67854-9320 - Hospital subgroups
- Acute care, Long-term, Swing-bed approved
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Sidni Durler |
W-2 Managing Employee | Dec 1, 2021 | |
| Lonnie Ruff |
Corporate Director |
Jan 1, 2022 | |
| Stacey Briggs |
W-2 Managing Employee |
Jul 30, 2025 | |
| County of Hodgeman |
5% Or Greater Direct Ownership Interest | Apr 12, 1970 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030922000040 | KS | Part a Provider - Critical Access Hospital | 5799696894 |
Receives reassigned benefits from 17 practitioners Practice locations: Jetmore, KS |
| O20041012000779 | KS | Part B Supplier - Clinic/Group Practice | 5799696894 |
Receives reassigned benefits from 20 practitioners 2 other NPIs on this enrollment Practice locations: Jetmore, KS |
National Provider Directory
Locations
809 W Bramley St
#310
Jetmore, KS 67854
Phone (620) 357-8361
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | HO42001 | KS | Yes |
Addresses
Primary practice location
809 W. Bramley Street
# 310
Jetmore, KS 67854-9320
Mailing address
809 W Bramley St
P.O. Box 310
Jetmore, KS 67854-9320
Phone (620) 357-8361
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100099040C | Medicaid | KS | |
| 100244010C | Medicaid | KS | |
| 000171 | Other | BLUE CROSS | |
| 100099040A | Medicaid | KS | |
| 100106840A | Medicaid | KS |
Other providers in Jetmore, KS
- Anjali Giri
- Nicole Hergert
- Hodgeman County Health Center
- Hodgeman County Health Center
- Hodgeman County Health Center
- Hodgeman County Medical Services
- Hodgeman County Pharmacy LLC
- Hodgeman County Pharmacy LLC
- John Reno
- Rachel Moore
All providers in Jetmore, KS · Critical Access Hospital in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.