NPIMap

Organization Active NPI

Ellsworth County Medical Center

Doing business as ECMC Rural Health Clinic Ellsworth

  • Rural Health Clinic/Center
  • Ellsworth, KS
National Provider Identifier
1972504546
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ELLSWORTH COUNTY MEDICAL CENTER
Doing business as
ECMC Rural Health Clinic Ellsworth
Practice address
1602 N Aylward Ave
Ellsworth, KS 67439-2541
Phone
(785) 472-3111
Fax
(785) 472-5639
NPI assigned
Aug 9, 2005
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
James Kirkbride
Title
Ceo
Phone
(785) 472-3111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X KS
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1602 N Aylward Ave
Ellsworth, KS 67439-2541

Mailing address

1602 N Aylward Ave
Ellsworth, KS 67439-2541
Phone (785) 472-3111

Other names 1

  • ECMC Rural Health Clinic Ellsworth Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040220000042 KS Part A Provider - Rural Health Clinic 5395643357 Practice locations: Ellsworth, KS
O20040716000216 KS Part B Supplier - Clinic/Group Practice 5395643357 Receives reassigned benefits from 35 practitioners
2 other NPIs on this enrollment
Practice locations: Ellsworth, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972504546. Details of each certification follow.

Rural health clinic certification: CCN 173497

Legal name
ELLSWORTH COUNTY MEDICAL CENTER
Doing business as
ECMC RURAL HEALTH CLINIC ELLSWORTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2001
Last certification
Nov 23, 2010
Ownership / control type
2A
Organization structure
GovernmentNon-profit
Enrollment address
1602 N Aylward Ave
Ellsworth, KS 67439-2541
Related CCNs
173497, 178952

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0452446Ecmc - Rural Health Clinic1602 Aylward Ave, Ellsworth, KS 67439Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Clint Rogers Individual Corporate DirectorVice Chair Jan 1, 2021
Brandy Thornton Individual Corporate DirectorCfo Mar 19, 2024
W-2 Managing EmployeeCfo Mar 19, 2024
James Kirkbride Individual Corporate DirectorCeo Jun 24, 2021
W-2 Managing EmployeeCeo Jun 24, 2021
Karen Pauley Individual Corporate DirectorTreasurer Jan 1, 2021
Kenneth L Beneda Individual Corporate DirectorChairman Jan 1, 2021

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ecmc- Rural Health Clinic WilsonWilson, KS, CCN 178500 Rural health clinic Operational/Managerial Control (100%) Jul 29, 2005

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 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1972504546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 N AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KIRKBRIDE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-472-3111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECMC Rural Health Clinic Ellsworth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ECMC Rural Health Clinic Ellsworth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellsworth, KS

Sources for this page

Verify at the official NPI Registry.