NPIMap

Organization Active NPI

Avera St Anthonys Hospital

  • Critical Access Hospital
  • O'Neill, NE
National Provider Identifier
1891738936
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
410002 Issued in NE
Legal business name
AVERA ST ANTHONYS HOSPITAL
Doing business as
Avera St. Anthony's Hospital
Practice address
300 N 2ND St
O'Neill, NE 68763-1514
Phone
(402) 336-2611
NPI assigned
Jun 14, 2006
Last updated
Jul 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Mr. Todd E. Consbruck
Title
Ceo
Phone
(402) 336-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 410002 NE Primary

Addresses

Primary practice location

300 N 2ND St
O'Neill, NE 68763-1514

Mailing address

PO Box 270
Oneill, NE 68763-0270
Phone (402) 336-5154

Other names 1

  • Avera St. Anthony's Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000149 NE Part A Provider - Critical Access Hospital 4486548203 Receives reassigned benefits from 85 practitioners
Practice locations: Oneill, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891738936. Details of each certification follow.

Hospital certification: CCN 281329

Legal name
AVERA ST ANTHONYS HOSPITAL
Doing business as
AVERA ST ANTHONYS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2000
Last certification
Mar 14, 2024
Beds
25
Ownership / control type
Church
Organization structure
CorporationNon-profit
Enrollment address
300 N 2ND St
Oneill, NE 68763-1514
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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Avera St Anthony's HospitalCCN 281329 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Anthonys Hosp Card Dep8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
James Francis Dover Individual Corporate OfficerFache, President/Ceo Avera Health Oct 23, 2023
Russell J McIntosh Individual Corporate DirectorBoard Member Jul 1, 2020
John Kozyra Individual Corporate OfficerPresident/Ceo Jan 29, 2024
Operational/Managerial ControlPresident/Ceo Jan 29, 2024
Jewel Swanson Individual Corporate DirectorBoard Member Jul 1, 2023
Mary B Wickersham Individual Corporate OfficerVice President Revenue Cycle Sep 1, 2019
Debra L Kelly Individual Corporate DirectorBoard Member Jul 1, 2020
Amanda Marie Schutz Individual Corporate OfficerBilling Services Officer Sep 1, 2019
Susan Dennis Individual Corporate DirectorBoard Member Jul 1, 2022
Barton Becker Individual Corporate DirectorBoard Member Jul 1, 2021
Sacred Heart Health Services Organization, Yankton, SD Non-profit Operational/Managerial Control Feb 1, 1998
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Bonita Gacnik Individual Corporate DirectorBoard Member Jul 1, 2022
Avera Health Organization, Sioux Falls, SD Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2000 100%
Operational/Managerial Control Sep 1, 2000
Amy Shane Individual Corporate DirectorBoard Member Jul 1, 2020
Cody Boettcher Individual Corporate DirectorBoard Member Jul 1, 2023
Merri Schneider Individual Corporate DirectorBoard Member Jul 1, 2020
Mark Hunhoff Individual Corporate DirectorBoard Member Jul 1, 2023

Owners & managing parties with NPI records 18

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

View all 18

Facilities with the same owner 96

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 96

Subparts reporting this organization as parent 8

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 85

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 85

Affiliated clinicians 100

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 100

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1891738936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687630270",
            "telephone_number": "402-336-5154",
            "fax_number": "402-336-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 2ND ST",
            "city": "O'NEILL",
            "state": "NE",
            "postal_code": "687631514",
            "telephone_number": "402-336-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVERA ST ANTHONYS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "CONSBRUCK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-336-2611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "410002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avera St. Anthony's Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avera St. Anthony's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Neill, NE

Sources for this page

Verify at the official NPI Registry.