NPIMap

Organization Active NPI

Gothenburg Memorial Hospital

Doing business as Gothenburg Health

  • Critical Access Hospital
  • Gothenburg, NE
National Provider Identifier
1922051531
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
GOTHENBURG MEMORIAL HOSPITAL
Doing business as
Gothenburg Health
Practice address
910 20TH St
Gothenburg, NE 69138-1253
Phone
(308) 537-3661
Fax
(308) 537-3074
NPI assigned
May 18, 2006
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Andrew D Knust
Title
Ceo
Phone
(308) 537-3661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

910 20TH St
Gothenburg, NE 69138-1253

Mailing address

PO Box 469
Gothenburg, NE 69138-0469
Phone (308) 537-3661

Other names 1

  • Gothenburg Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050330001110 NE Part B Supplier - Clinic/Group Practice 6709832983 Receives reassigned benefits from 21 practitioners
1 other NPI on this enrollment
Practice locations: Gothenburg, NE
O20070123000252 NE Part A Provider - Critical Access Hospital 6709832983 Receives reassigned benefits from 20 practitioners
Practice locations: Gothenburg, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922051531. Details of each certification follow.

Hospital certification: CCN 281313

Legal name
GOTHENBURG MEMORIAL HOSPITAL
Doing business as
GOTHENBURG HEALTH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2000
Last certification
Jul 13, 2022
Beds
15
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
910 20TH St
Gothenburg, NE 69138-1253
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Gothenburg HealthCCN 281313 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

910 20th St
#469
Gothenburg, NE 69138
Phone (308) 537-3661

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Ryan O'Hare Individual Corporate Officer Jul 21, 2016
Corporate Director Jul 1, 2013
Michael Bacon Individual Corporate Officer Jun 1, 2008
Corporate Director Jun 1, 2000
Claudine N Kennicutt Individual Corporate Director Oct 18, 2023
Brady D Beecham Individual W-2 Managing EmployeeChief Medical Officer May 22, 2023
Operational/Managerial ControlChief Medical Officer May 22, 2023
Andrew D Knust Individual Corporate OfficerCeo Oct 1, 2022
W-2 Managing EmployeeCeo Oct 1, 2022
Operational/Managerial ControlCeo Oct 1, 2022
Monty Bowman Individual Corporate Officer Jun 1, 2008
Corporate Director Jun 1, 2000
David Jobman Individual Corporate Director Jul 21, 2016

Owners & managing parties with NPI records 1

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

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

Affiliated clinicians 68

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

View all 68

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1922051531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691380469",
            "telephone_number": "308-537-3661",
            "fax_number": "308-537-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 20TH ST",
            "city": "GOTHENBURG",
            "state": "NE",
            "postal_code": "691381253",
            "telephone_number": "308-537-3661",
            "fax_number": "308-537-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTHENBURG MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "KNUST",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "308-537-3661"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gothenburg Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gothenburg, NE

Sources for this page

Verify at the official NPI Registry.