NPIMap

Organization Active NPI

Sedgwick County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Julesburg, CO
National Provider Identifier
1912915943
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
1070 Issued in CO
Legal business name
SEDGWICK COUNTY MEMORIAL HOSPITAL
Practice address
900 Cedar St
Julesburg, CO 80737-1121
Phone
(970) 474-3323
Fax
(970) 474-2758
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Garnas
Title
Ceo
Phone
(970) 474-3323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 1070 CO Primary

Addresses

Primary practice location

900 Cedar St
Julesburg, CO 80737-1121

Mailing address

900 Cedar St
Julesburg, CO 80737-1121
Phone (970) 474-3323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090709000736 CO Part A Provider - Critical Access Hospital 1052201100 Practice locations: Julesburg, CO

Hospital certification: CCN 06Z310

Legal name
SEDGWICK COUNTY MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
900 Cedar Street
Julesburg, CO 80737-1121
Hospital Swing-Bed Unit

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
Valley Medical Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Karla Dunker Individual Corporate Director Jun 17, 2009
W-2 Managing Employee Jun 17, 2009
Sedgwick County Organization, Julesburg, CO Operational/Managerial Control May 1, 2009
Aidan Hettler Individual Corporate Officer Sep 22, 2022
Anita Nein Individual Corporate Director May 1, 2009
Kenneth Hodges Individual Corporate Director May 1, 2009
Rodney Green Individual Corporate Director Jan 1, 2019

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912915943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CEDAR ST",
            "city": "JULESBURG",
            "state": "CO",
            "postal_code": "807371121",
            "telephone_number": "970-474-3323",
            "fax_number": "970-474-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CEDAR ST",
            "city": "JULESBURG",
            "state": "CO",
            "postal_code": "807371121",
            "telephone_number": "970-474-3323",
            "fax_number": "970-474-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDGWICK COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARNAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-474-3323"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "CO",
            "license": "1070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Julesburg, CO

Sources for this page

Verify at the official NPI Registry.