NPIMap

Ellsworth County Medical Center

Organization Active NPI Rural Health Clinic/Center · Ellsworth, KS

NPI 1972504546 · NPPES record last updated Aug 11, 2025

Key facts

NPI
1972504546
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
ELLSWORTH COUNTY MEDICAL CENTER
Practice address
1602 N Aylward Ave
Ellsworth, KS 67439-2541
Phone
(785) 472-3111
Fax
(785) 472-5639
NPI assigned
Aug 9, 2005
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 5

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

Practitioners 39

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

View all 39

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0452446Ecmc - Rural Health Clinic
1602 Aylward Ave, Ellsworth, KS 67439		Certificate of waiverAug 31, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in KS

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
Government · Non-profit
Enrollment address
1602 N Aylward Ave
Ellsworth, KS 67439-2541
Related CCNs
173497, 178952

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 Director
Vice Chair		 Jan 1, 2021
Brandy Thornton
Individual 		Corporate Director
Cfo		 Mar 19, 2024
W-2 Managing Employee
Cfo		 Mar 19, 2024
James Kirkbride
Individual 		Corporate Director
Ceo		 Jun 24, 2021
W-2 Managing Employee
Ceo		 Jun 24, 2021
Karen Pauley
Individual 		Corporate Director
Treasurer		 Jan 1, 2021
Kenneth L Beneda
Individual 		Corporate Director
Chairman		 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 Wilson
Wilson, KS · CCN 178500		 Rural health clinic Operational/Managerial Control (100%) Jul 29, 2005

Medicare enrollment records

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

National Provider Directory

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
965OtherKSBCBS
30003930830004MedicaidKS

Other names

  • ECMC Rural Health Clinic Ellsworth Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 11, 2025.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "965",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003930830004",
            "state": "KS"
        }
    ],
    "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

All providers in Ellsworth, KS · Rural Health Clinic/Center in Kansas

Sources for this page

Verify at the official NPI Registry.