NPIMap

Organization Active NPI

Community Hospital Association

Doing business as Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • McCook, NE
National Provider Identifier
1912935602
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
320007 Issued in NE
Legal business name
COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Community Hospital
Practice address
1301 E H St
MC Cook, NE 69001-3482
Phone
(308) 344-2650
Fax
(308) 344-8358
NPI assigned
Jun 29, 2006
Last updated
Dec 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 320007 NE Primary
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 1

  • COMMUNITY HOSPITAL Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912935602. Details of each certification follow.

Hospital certification: CCN 28Z363

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

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
Community Hosp - Crna3 organizations share this tax ID, including this one
Part of
Community Hosp - Crna

Other organizations with this tax ID 2

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

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
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 EmployeeChief of Staff Jul 1, 2022
Operational/Managerial ControlChief 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 OfficerVice President Support Services Dec 12, 2016
W-2 Managing EmployeeVice President Support Services Dec 12, 2016
Operational/Managerial ControlVice President Support Services Dec 12, 2016
Molly L Herzberg Individual Corporate OfficerVP Clinical Services & Cno Mar 25, 2019
W-2 Managing EmployeeVP Clinical Services & Cno Mar 25, 2019
Operational/Managerial ControlVP Clinical Services & Cno Mar 25, 2019
Karen Kliment Thompson Individual Corporate OfficerVice President Ancillary Services Jun 15, 2011
W-2 Managing EmployeeVice President Ancillary Services Feb 13, 2006
Operational/Managerial ControlVice President Ancillary Services Feb 13, 2006
Troy a Bruntz Individual Corporate OfficerPresident & Ceo Jun 15, 2011
W-2 Managing EmployeePresident & Ceo Jun 30, 2003
Operational/Managerial ControlPresident & Ceo Jun 30, 2003
Sean Wolfe Individual Corporate OfficerCfo Nov 16, 2016
W-2 Managing EmployeeCfo Oct 19, 2016
Operational/Managerial ControlCfo 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

Owners & managing parties with NPI records 2

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

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.

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1912935602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690011328",
            "telephone_number": "308-344-8303",
            "fax_number": "308-344-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E H ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013482",
            "telephone_number": "308-344-2650",
            "fax_number": "308-344-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL ASSOCIATION",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-12-22",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "BRUNTZ",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "308-344-8315",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NE",
            "license": "320007",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NE",
            "license": "320007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "communityhospitalmccook@chm.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1301 E H St",
            "city": "Mc Cook",
            "state": "NE",
            "country_code": "US",
            "postal_code": "690013482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "COMMUNITY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMMUNITY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McCook, NE

Sources for this page

Verify at the official NPI Registry.