Clay County Medical Center
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Clay Center, KS
NPI 1841245396 · NPPES record last updated Dec 4, 2017
Key facts
- NPI
- 1841245396
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- H014001 (KS)
- Legal business name
- CLAY COUNTY MEDICAL CENTER
- Practice address
- 617 Liberty St
Clay Center, KS 67432-1564 - Phone
- (785) 632-2144
- Fax
- (785) 632-3352
- NPI assigned
- May 23, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CLAY COUNTY MEDICAL CENTER
Authorized official
- Name
- Austin Gillard
- Title
- Ceo
- Phone
- (785) 632-2144
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 8
Related certifications (CCN) 1
Practitioners 44
-
Linda Marie Bott, ARNP
-
Pamela D Brabec, APRN-C
-
Ryan David Brantley, P.A
-
Arnold R Cabrera, MD
-
Adam J Chase, M.D.
-
Pamela B Davis, MD
-
Wendy Lee Gibson, PMHNP
-
Austin Keith Gydesen, APRN
-
Crystal Lynn Hathorne, APRN, PMHNP-BC
-
Carissa A Horton, P.A.-C
-
Alya M Houghton, APRN
-
Ray E House, MD
-
Elizabeth A Koerner, M.D.
-
Patrik Charles Leonard, M.D.
-
Allie B Lohrmeyer, M.D.
-
Mindy Sue Lovendahl, APRN
Affiliated clinicians 6
-
Allie B Lohrmeyer, M.D.
-
Cary Murphy, M.D.
-
Timothy M. Penner, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Hospital certification: CCN 17Z371
- Legal name
- CLAY COUNTY MEDICAL CENTER
- Organization structure
- Other · Non-profit
- Enrollment address
- 617 Liberty St
Clay Center, KS 67432-1564
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey D Yarrow |
Corporate Director | Apr 12, 2006 | |
| Lori J Penner |
Corporate Director | Apr 12, 2006 | |
| Austin Gillard |
Corporate Officer |
May 4, 2015 | |
| Corporate Director |
May 4, 2015 | ||
| W-2 Managing Employee |
May 4, 2015 | ||
| Angela Kobel |
Corporate Officer |
May 6, 2025 | |
| W-2 Managing Employee |
May 6, 2025 | ||
| Operational/Managerial Control |
May 6, 2025 | ||
| Richard H Cott |
Corporate Director | Jan 12, 2009 | |
| Sandy M Fox |
Corporate Director | Apr 12, 2006 | |
| Terri L Parry |
Corporate Director | Jan 30, 2007 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Clay County Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (5%) Operational/Managerial Control (100%) |
Jul 1, 2016 Jul 1, 2016 |
| Clyde Family Physicians |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2016 Jul 1, 2016 |
| Clay Center Family Physicians |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2016 Jul 1, 2016 |
| Linn Family Physicians |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2016 Jul 1, 2016 |
| Riley Family Physicians |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 28, 2020 Sep 28, 2020 |
| Glasco Family Physicians |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 1, 2021 Sep 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090731000442 | KS | Part a Provider - Critical Access Hospital | 6901959436 | Practice locations: Clay Center, KS |
National Provider Directory
- Tax ID family
- Clay County Medical Center
- Part of
- Clay County Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | H014001 | KS | Yes |
| Critical Access Hospital | 282NC0060X | H014001 | KS |
Addresses
Primary practice location
617 Liberty St
Clay Center, KS 67432-1564
Mailing address
PO Box 512
Clay Center, KS 67432-0512
Phone (785) 632-2144
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1591 | Other | KS | BLUE CROSS SWING BED |
| 100098830A | Medicaid | KS |
Other providers in Clay Center, KS
- Clay County Medical Center
- Clay County Medical Center
- Clay County Medical Center
- Clay County Medical Center
- Clay County Medical Center
- Kyle Converse
- Tammera Converse
- County of Clay
- County of Clay
- Mary Kay Cummins
All providers in Clay Center, KS · Medicare Defined Swing Bed Hospital Unit in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2017. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.