NPIMap

Organization Active NPI

Sheridan County Hospital

Doing business as Hoxie Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Hoxie, KS
National Provider Identifier
1942316799
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SHERIDAN COUNTY HOSPITAL
Doing business as
Hoxie Medical Clinic
Practice address
826 18TH St Ste a
Box 415
Hoxie, KS 67740-4373
Phone
(785) 675-3018
Fax
(785) 675-2306
NPI assigned
Aug 22, 2006
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SHERIDAN COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Authorized official

Name
Mrs. Niceta B Farber
Title
Ceo/Administrator
Phone
(785) 675-3281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

826 18TH St Ste a
Box 415
Hoxie, KS 67740-4373

Mailing address

826 18TH St Ste a
PO Box 415
Hoxie, KS 67740-4373
Phone (785) 675-3018

Other identifiers 3

IdentifierTypeStateIssuer
100009640BMedicaidKS
110255OtherKSBLUE CROSS
1188OtherKSBLUE CROSS RHC

Other names 1

  • Hoxie Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050211000547 KS Part B Supplier - Clinic/Group Practice 7416842380 Receives reassigned benefits from 13 practitioners
3 other NPIs on this enrollment
Practice locations: Hoxie, KS; Oakley, KS; Quinter, KS
O20150714001675 KS Part A Provider - Federally Qualified Health Center (FQHC) 7416842380 Practice locations: Hoxie, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942316799. Details of each certification follow.

Federally qualified health center certification: CCN 171863

Legal name
SHERIDAN COUNTY HOSPITAL
Doing business as
HOXIE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 30, 2015
Last certification
Sep 30, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1982 in KS
Enrollment address
826 18TH St
Ste a
Hoxie, KS 67740-4373

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Hoxie Dental Clinic

Locations

826 18th St
Hoxie, KS 67740
Phone (785) 675-3018

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
Lester Keith Caldwell Individual Corporate Officer May 7, 2015
Chad Koster Individual Corporate Officer Feb 10, 2022
W-2 Managing EmployeeCeo Feb 10, 2022
County of Sheridan Organization, Hoxie, KS Non-profit Operational/Managerial Control Jan 1, 1966
Kenneth Eland Individual Corporate Officer May 7, 2015
Joy Bretz Individual Corporate Officer May 7, 2015
Sheridan County Hospital Organization, Hoxie, KS Non-profit Other Jan 1, 1966 100%
Lucille Heim Individual Corporate Officer May 7, 2015
Leanna Sloan Individual Corporate Officer May 7, 2015

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Selden Community ClinicSelden, KS, CCN 171868 Federally qualified health center Operational/Managerial Control (100%)
Other (100%)		 Jun 1, 2015
Jun 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1942316799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 18TH ST STE A",
            "address_2": "PO BOX 415",
            "city": "HOXIE",
            "state": "KS",
            "postal_code": "677404373",
            "telephone_number": "785-675-3018",
            "fax_number": "785-675-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 18TH ST STE A",
            "address_2": "BOX 415",
            "city": "HOXIE",
            "state": "KS",
            "postal_code": "677404373",
            "telephone_number": "785-675-3018",
            "fax_number": "785-675-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHERIDAN COUNTY HOSPITAL",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "FARBER",
        "authorized_official_first_name": "NICETA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "785-675-3281",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009640B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "110255",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RHC",
            "identifier": "1188",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hoxie Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hoxie, KS

Sources for this page

Verify at the official NPI Registry.