NPIMap

Organization Active NPI

City of Crawford

  • Skilled Nursing Facility
  • Crawford, NE
National Provider Identifier
1922033273
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
214002 Issued in NE
Legal business name
CITY OF CRAWFORD
Practice address
1 Paddock St
Crawford, NE 69339-1143
Phone
(308) 665-1224
Fax
(308) 665-2450
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Ms. Kathy Andersen, NHA
Title
Administrator
Phone
(308) 665-1224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 214002 NE Primary

Addresses

Primary practice location

1 Paddock St
Crawford, NE 69339-1143

Mailing address

PO Box 526
1 Paddock St
Crawford, NE 69339-0526
Phone (308) 665-1224

Other names 1

  • Ponderosa Villa Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111006000730 NE Part A Provider - Skilled Nursing Facility 7113836693 Practice locations: Crawford, NE

Skilled nursing facility certification: CCN 285250

Legal name
CITY OF CRAWFORD
Doing business as
PONDEROSA VILLA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 2003
Last certification
Nov 21, 2024
Beds
39
Ownership / control type
City
Organization structure
GovernmentNon-profit
Enrollment address
755 1St St
Crawford, NE 69339-1186
Nursing home name
PONDEROSA VILLA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ponderosa VillaCCN 285250
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - City
Certified
Jun 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3928.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
City of Crawford2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Edward Pelton Individual Operational/Managerial Control Aug 1, 2025
Adp of the SNF Aug 1, 2025
City of Crawford Organization, Crawford, NE Non-profit Adp of the SNF Jan 16, 1972
Direct Ownership Interest Jan 16, 1972 100%
Cascades Healthcare LLC Organization, Provo, UT Corporation, LLC, Management services company Operational/Managerial Control Aug 1, 2025
Adp of the SNF Oct 8, 2025
Kris Mader Individual Corporate DirectorBoard Member Aug 1, 2025 25%
Managing Control - Governing BodyBoard of Directors Aug 1, 2025
Adp of the SNF Aug 1, 2025
Charlene Zander Individual Operational/Managerial Control Aug 1, 2025
Adp of the SNF Aug 1, 2025
Rhonda Schoenemann Individual Corporate DirectorBoard Member Chair Aug 1, 2025 25%
Managing Control - Governing BodyBoard of Directors Aug 1, 2025
Adp of the SNF Aug 1, 2025
Twila Vogl Individual Corporate DirectorBoard Member Aug 1, 2025 25%
Managing Control - Governing BodyBoard of Directors Aug 1, 2025
Adp of the SNF Aug 1, 2025
Ralene J Suchor Individual Corporate DirectorBoard Member Secretary Aug 1, 2025 25%
Managing Control - Governing BodyBoard of Directors Aug 1, 2025
Adp of the SNF Aug 1, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 4

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1922033273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526",
            "address_2": "1 PADDOCK ST",
            "city": "CRAWFORD",
            "state": "NE",
            "postal_code": "693390526",
            "telephone_number": "308-665-1224",
            "fax_number": "308-665-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PADDOCK ST",
            "city": "CRAWFORD",
            "state": "NE",
            "postal_code": "693391143",
            "telephone_number": "308-665-1224",
            "fax_number": "308-665-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CRAWFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-665-1224",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "214002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponderosa Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crawford, NE

Sources for this page

Verify at the official NPI Registry.