Community Hospital Association

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · MC Cook, NE

NPI 1912935602 · NPPES record last updated Dec 22, 2020

Key facts

NPI
1912935602
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
320007 (NE)
Legal business name
COMMUNITY HOSPITAL ASSOCIATION
Practice address
1301 E H St
MC Cook, NE 69001-3482
Phone
(308) 344-2650
Fax
(308) 344-8358
NPI assigned
Jun 29, 2006
Organization subpart
Yes
Parent organization (as reported)
COMMUNITY HOSPITAL ASSOCIATION

Authorized official

Name
Mr. Troy A Bruntz
Title
President & Ceo
Phone
(308) 344-8315

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.

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 2

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.

Practitioners 26

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

View all 26

Affiliated clinicians 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

Hospital certification: CCN 28Z363

Legal name
COMMUNITY HOSPITAL ASSOCIATION
Doing business as
COMMUNITY HOSPITAL
Organization structure
Corporation · Non-profit
Incorporated
Sep 4, 1970 in NE
Enrollment address
1301 E H St
McCook, NE 69001-3482
Main/Primary Hospital Location

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
Michael C Lord
Individual
Corporate Officer Dec 20, 2023
Corporate Director May 18, 2022
Jana J Kmoch
Individual
Corporate Director Dec 19, 2018
Lorinda L Reece
Individual
Contracted Managing Employee
Chief of Staff
Jul 1, 2022
Operational/Managerial Control
Chief of Staff
Jul 1, 2022
Kurt R Vosburg
Individual
Corporate Officer Dec 20, 2023
Corporate Director Dec 15, 2021
Grant R Norgaard
Individual
Corporate Director Dec 20, 2023
Matthew G Nielsen
Individual
Corporate Officer Dec 21, 2022
Corporate Director Dec 15, 2021
Lori a Beeby
Individual
Corporate Officer
Vice President Support Services
Dec 12, 2016
W-2 Managing Employee
Vice President Support Services
Dec 12, 2016
Operational/Managerial Control
Vice President Support Services
Dec 12, 2016
Molly L Herzberg
Individual
Corporate Officer
VP Clinical Services & Cno
Mar 25, 2019
W-2 Managing Employee
VP Clinical Services & Cno
Mar 25, 2019
Operational/Managerial Control
VP Clinical Services & Cno
Mar 25, 2019
Karen Kliment Thompson
Individual
Corporate Officer
Vice President Ancillary Services
Jun 15, 2011
W-2 Managing Employee
Vice President Ancillary Services
Feb 13, 2006
Operational/Managerial Control
Vice President Ancillary Services
Feb 13, 2006
Troy a Bruntz
Individual
Corporate Officer
President & Ceo
Jun 15, 2011
W-2 Managing Employee
President & Ceo
Jun 30, 2003
Operational/Managerial Control
President & Ceo
Jun 30, 2003
Sean Wolfe
Individual
Corporate Officer
Cfo
Nov 16, 2016
W-2 Managing Employee
Cfo
Oct 19, 2016
Operational/Managerial Control
Cfo
Oct 19, 2016
Karen J Craw
Individual
Corporate Director Dec 20, 2023
Darren Esch
Individual
Corporate Officer Dec 15, 2021
Corporate Director Dec 16, 2020
Matthew B Davidson
Individual
Corporate Director Dec 21, 2022
Ashley Marie Vontz
Individual
Corporate Director Dec 21, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100908000880 NE Part a Provider - Critical Access Hospital 9133101629 Practice locations: McCook, NE

National Provider Directory

Tax ID family
Community Hospital Association (3 organizations share this tax ID)
Part of
Community Hospital Association

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 320007 NE Yes
Critical Access Hospital 282NC0060X 320007 NE

Addresses

Primary practice location

1301 E H St
MC Cook, NE 69001-3482

Mailing address

PO Box 1328
MC Cook, NE 69001-1328
Phone (308) 344-8303

Other names

  • COMMUNITY HOSPITAL Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address communityhospitalmccook@chm.medalliesdirect.net Direct

Other providers in MC Cook, NE

All providers in MC Cook, NE · Medicare Defined Swing Bed Hospital Unit in Nebraska

Sources for this page

Verify at the official NPI Registry.