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Avera St Anthonys Hospital

Organization Active NPI Critical Access Hospital · O'Neill, NE

NPI 1891738936 · NPPES record last updated Jul 6, 2021

Key facts

NPI
1891738936
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
410002 (NE)
Legal business name
AVERA ST ANTHONYS HOSPITAL
Practice address
300 N 2ND St
O'Neill, NE 68763-1514
Phone
(402) 336-2611
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 18

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

Other NPIs with the same Medicare PAC ID 4

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

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.

Corporate family (same tax ID) 7

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

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

Facilities with the same owner 96

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

View all 96

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 87

Affiliated clinicians 100

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

View all 100

Medicare Care Compare: Hospital

Listed as
Avera St Anthony'S Hospital CCN 281329
Overall star rating
★★★★☆ 4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

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
Corporation · Non-profit
Enrollment address
300 N 2ND St
Oneill, NE 68763-1514
Other Hospital Practice Location

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 Officer
Fache, President/Ceo Avera Health		 Oct 23, 2023
Russell J McIntosh
Individual 		Corporate Director
Board Member		 Jul 1, 2020
John Kozyra
Individual 		Corporate Officer
President/Ceo		 Jan 29, 2024
Operational/Managerial Control
President/Ceo		 Jan 29, 2024
Jewel Swanson
Individual 		Corporate Director
Board Member		 Jul 1, 2023
Mary B Wickersham
Individual 		Corporate Officer
Vice President Revenue Cycle		 Sep 1, 2019
Debra L Kelly
Individual 		Corporate Director
Board Member		 Jul 1, 2020
Amanda Marie Schutz
Individual 		Corporate Officer
Billing Services Officer		 Sep 1, 2019
Susan Dennis
Individual 		Corporate Director
Board Member		 Jul 1, 2022
Barton Becker
Individual 		Corporate Director
Board Member		 Jul 1, 2021
Sacred Heart Health Services
Organization · Yankton, SD
Non-profit 		Operational/Managerial Control Feb 1, 1998
Julie Lautt
Individual 		Corporate Officer
Cfo		 Mar 1, 2020
Bonita Gacnik
Individual 		Corporate Director
Board 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 Director
Board Member		 Jul 1, 2020
Cody Boettcher
Individual 		Corporate Director
Board Member		 Jul 1, 2023
Merri Schneider
Individual 		Corporate Director
Board Member		 Jul 1, 2020
Mark Hunhoff
Individual 		Corporate Director
Board Member		 Jul 1, 2023

Medicare enrollment records

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

National Provider Directory

Tax ID family
St Anthonys Hosp Card Dep (8 organizations share this tax ID)

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
H00118OtherNEBC-NE HOSP PROV #
H136OtherNEMIDLANDS CHOICE PROVIDER

Other names

  • Avera St. Anthony's Hospital Doing business as

Other providers in O'Neill, NE

All providers in O'Neill, NE · Critical Access Hospital in Nebraska

Sources for this page

Verify at the official NPI Registry.