NPIMap

Organization Active NPI

Beatrice Community Hospital & Health Center Inc

Doing business as Wymore Medical Clinic

  • Rural Health Clinic/Center
  • Wymore, NE
National Provider Identifier
1871608174
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC
Practice address
116 E H St
Wymore, NE 68466-1702
Phone
(402) 645-3310
Fax
(402) 645-3397
NPI assigned
Aug 20, 2006
Last updated
Sep 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BEATRICE COMMUNITY HOSPITAL & HEALTH CEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Chad Jurgens
Title
Cfo
Phone
(402) 223-7224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

116 E H St
Wymore, NE 68466-1702

Mailing address

PO Box 278
Beatrice, NE 68310-0278
Phone (402) 228-3344

Other identifiers 10

IdentifierTypeStateIssuer
2281OtherNEMIDLANDS CHOICE #DH
1935OtherNEMIDLANDS CHOICE DW
30327OtherNEBC #DW
37668OtherNEBC # DH
47037984003OtherNETRICARE PROVIDER #
37665OtherNEBC # SL
7928OtherNEMIDLANDS CHOICE #JC
30768OtherNEBLUE CROSS CLINIC #
230068OtherNEMIDLANDS CHOICE #SL
32297OtherNEBC # JC

Other names 1

  • Wymore Medical Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050127000781 NE Part A Provider - Rural Health Clinic 1951208222 Practice locations: Wymore, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871608174. Details of each certification follow.

Rural health clinic certification: CCN 283415

Legal name
BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC
Doing business as
WYMORE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 13, 1995
Last certification
Jun 4, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Feb 13, 1995 in NE
Enrollment address
116 E H St
Wymore, NE 68466-1702
Related CCNs
281364

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Beatrice Community Hospital7 organizations share this tax ID, including this one
Part of
Beatrice Community Hospital

Other organizations with this tax ID 6

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

Locations

116 E H St
Wymore, NE 68466
Phone (402) 645-3310

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Richard Haraldson Individual Corporate OfficerCeo Jan 1, 2018
W-2 Managing EmployeeCeo Jan 1, 2018
Ryan Trauernicht Individual Corporate DirectorBoard Member Jan 1, 2021
Chad E Jurgens Individual W-2 Managing EmployeeCfo Nov 18, 2019
Operational/Managerial ControlCfo Nov 18, 2019
Eric Trusty Individual W-2 Managing EmployeePractice Administrator Mar 10, 2016
Operational/Managerial ControlPractice Administrator Mar 10, 2016
Rodney Ensz Individual Corporate OfficerSecretary Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2019
Deanne Caspers Moon Individual Corporate DirectorBoard Member Jan 1, 2017
Steve Sandman Individual Corporate OfficerChairman Jan 1, 2016
Corporate DirectorBoard Member Jan 1, 2016
Le Roy J Janzen Individual Corporate OfficerVice Chairman Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2008
Jennifer Elliott Individual Corporate DirectorBoard Member Jan 1, 2023
Susan Hartley Individual Corporate DirectorBoard Member Jan 1, 2022
Deann C Paulson Individual Corporate DirectorBoard Member Jan 1, 2022
Craig Zarybnicky Individual Corporate DirectorBoard Member Jan 1, 2020
Brenda McNiff Individual Corporate DirectorBoard Member Jan 31, 2014
Benjamin J Thayer Individual Corporate DirectorBoard Member Jan 1, 2022
Bruce Vitosh Individual Corporate OfficerTreasurer Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2016

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1871608174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683100278",
            "telephone_number": "402-228-3344",
            "fax_number": "402-223-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E H ST",
            "city": "WYMORE",
            "state": "NE",
            "postal_code": "684661702",
            "telephone_number": "402-645-3310",
            "fax_number": "402-645-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEATRICE COMMUNITY HOSPITAL & HEALTH CE",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "JURGENS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-223-7224"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE #DH",
            "identifier": "2281",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE DW",
            "identifier": "1935",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC #DW",
            "identifier": "30327",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC # DH",
            "identifier": "37668",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER #",
            "identifier": "47037984003",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC # SL",
            "identifier": "37665",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE #JC",
            "identifier": "7928",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CLINIC #",
            "identifier": "30768",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE #SL",
            "identifier": "230068",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC # JC",
            "identifier": "32297",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wymore Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wymore Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wymore Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wymore, NE

Sources for this page

Verify at the official NPI Registry.