NPIMap

Organization Active NPI

Hillsboro Hospital LLC

Doing business as Hillsboro Community Hospital

  • Rural Health Clinic/Center
  • Hillsboro, KS
National Provider Identifier
1982242152
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HILLSBORO HOSPITAL LLC
Doing business as
Hillsboro Community Hospital
Practice address
101 Industrial Rd
Hillsboro, KS 67063-9602
Phone
(620) 947-3114
NPI assigned
Dec 18, 2019
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Darrel Morris
Title
Coo
Phone
(918) 527-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

101 Industrial Rd
Hillsboro, KS 67063-9602

Mailing address

101 Industrial Rd
Hillsboro, KS 67063-9602
Phone (620) 947-3114

Other names 1

  • Hillsboro Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219000430 KS Part A Provider - Rural Health Clinic 4587090121 Practice locations: Hillsboro, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982242152. Details of each certification follow.

Rural health clinic certification: CCN 178567

Legal name
HILLSBORO HOSPITAL LLC
Doing business as
HILLSBORO CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 20, 2011
Last certification
Oct 5, 2020
Ownership / control type
1B
Most recent change of ownership
Dec 9, 2019 (1 total)
Organization structure
LLCProprietary
Enrollment address
101 Industrial Rd
Hillsboro, KS 67063-9602
Related CCNs
171357

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Hillsboro Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Darrel W Morris Individual 5% Or Greater Indirect Ownership InterestCeo Dec 9, 2019 16.22%
Corporate OfficerCeo Dec 9, 2019 16.22%
Corporate DirectorCeo Dec 9, 2019 16.22%
Operational/Managerial ControlCeo Dec 9, 2019 16.22%
RHG Consolidated LLC Organization, Kansas City, MO LLC, Management services company, For-profit 5% Or Greater Direct Ownership Interest Dec 9, 2019 100%
Operational/Managerial Control Dec 9, 2019 100%
Phyllis Shaffer Individual Corporate DirectorInvestor Jan 1, 2025 6.08%
Lawrence J Arthur Individual 5% Or Greater Indirect Ownership Interest Dec 9, 2019 16.67%
Trent M Skaggs Individual 5% Or Greater Indirect Ownership InterestInvestor Dec 9, 2019 16.67%
Corporate OfficerInvestor Dec 9, 2019 16.67%
Corporate DirectorInvestor Dec 9, 2019 16.67%
Operational/Managerial ControlInvestor Dec 9, 2019 16.67%
LG Medical LLC Organization, Kansas City, MO LLC, Investment firm 5% Or Greater Indirect Ownership Interest Jan 1, 2025 12.97%
Brent Lagergren Individual 5% Or Greater Indirect Ownership InterestAttorney Dec 9, 2019 6.09%
Corporate OfficerAttorney Dec 9, 2019 6.09%
Billy W May Individual 5% Or Greater Indirect Ownership InterestInvestor Dec 9, 2019 5.63%
Corporate OfficerInvestor Dec 9, 2019 5.63%
Corporate Director Dec 9, 2019 5.63%
Dennis L Davis Individual 5% Or Greater Indirect Ownership InterestInvestor Dec 9, 2019 16.67%
Jami Homfeld Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2025

Facilities with the same owner 11

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

Change-of-ownership history 1

DateEventCounterparty
Dec 9, 2019 Change of OwnershipThis provider was the buyer Hillsboro ClinicCCN 178567, KS, NPI 1063792919

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1982242152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 INDUSTRIAL RD",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "670639602",
            "telephone_number": "620-947-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 INDUSTRIAL RD",
            "city": "HILLSBORO",
            "state": "KS",
            "postal_code": "670639602",
            "telephone_number": "620-947-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSBORO HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "DARREL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "918-527-1234"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsboro Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hillsboro, KS

Sources for this page

Verify at the official NPI Registry.