NPIMap

Organization Active NPI

Callaway Hospital District

Doing business as Callaway District Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Callaway, NE
National Provider Identifier
1871600981
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
100002 Issued in NE
Legal business name
CALLAWAY HOSPITAL DISTRICT
Doing business as
Callaway District Hospital
Practice address
211 E Kimball St
Callaway, NE 68825-2597
Phone
(308) 836-2228
Fax
(308) 836-2733
NPI assigned
Aug 24, 2006
Last updated
Jan 16, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CALLAWAY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Mr. Brett D. Eggleston
Title
Ceo
Phone
(308) 836-2228

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 100002 NE Primary
Critical Access Hospital 282NC0060X 100002 NE

Addresses

Primary practice location

211 E Kimball St
Callaway, NE 68825-2597

Mailing address

PO Box 100
Callaway, NE 68825-0100
Phone (308) 836-2228

Other identifiers 1

IdentifierTypeStateIssuer
00452OtherNEBCBS OF NEBRASKA

Other names 1

  • Callaway District Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000847 NE Part A Provider - Critical Access Hospital 0143208983 Practice locations: Callaway, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871600981. Details of each certification follow.

Hospital certification: CCN 28Z335

Legal name
CALLAWAY HOSPITAL DISTRICT
Doing business as
CALLAWAY DISTRICT HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
211 E Kimball St
Callaway, NE 68825-2597
Other Hospital Practice Location

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
Callaway District Hospital5 organizations share this tax ID, including this one
Part of
Callaway District Hospital

Other organizations with this tax ID 4

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

Locations

211 E Kimball St
Callaway, NE 68825
Phone (308) 836-2228

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Cassie D Penn Individual W-2 Managing EmployeeCoo Dec 4, 2023
Operational/Managerial ControlCoo Dec 4, 2023
Gregory Johnson Individual Corporate Officer Jun 18, 2013
Corporate Director Jun 1, 2000
Mary Ross Individual Corporate Officer Jun 1, 1998
Corporate Director Jun 1, 1998
Kenneth L Loper Individual W-2 Managing EmployeeChief of Staff Nov 19, 2014
Operational/Managerial ControlChief of Staff Nov 19, 2014
Zachary Meyer Individual Corporate Officer Jul 16, 2019
Corporate Director Jul 16, 2019
James Jenkins Individual Corporate Director Apr 16, 2019
Brett D Eggleston Individual Corporate OfficerCeo Jun 20, 2017
W-2 Managing EmployeeCeo Sep 1, 2016
Operational/Managerial ControlCeo Sep 1, 2016
Mark Kimball Individual Corporate Director Jun 1, 1998

Owners & managing parties with NPI records 2

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

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

Affiliated clinicians 2

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1871600981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "CALLAWAY",
            "state": "NE",
            "postal_code": "688250100",
            "telephone_number": "308-836-2228",
            "fax_number": "308-836-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E KIMBALL ST",
            "city": "CALLAWAY",
            "state": "NE",
            "postal_code": "688252597",
            "telephone_number": "308-836-2228",
            "fax_number": "308-836-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLAWAY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALLAWAY HOSPITAL DISTRICT",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-836-2228",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "100002",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "100002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "00452",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callaway District Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Callaway District Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Callaway, NE

Sources for this page

Verify at the official NPI Registry.