NPIMap

Organization Active NPI

Great Plains of Cheyenne Co Inc

Doing business as Cheyenne County Clinic

  • Rural Health Clinic/Center
  • Saint Francis, KS
National Provider Identifier
1982644936
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREAT PLAINS OF CHEYENNE CO INC
Doing business as
Cheyenne County Clinic
Practice address
221 W First
Saint Francis, KS 67756-1075
Phone
(785) 332-2682
Fax
(785) 332-2516
NPI assigned
Jun 7, 2006
Last updated
Feb 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Jeremy Michael Clingenpeel
Title
Ceo
Phone
(785) 332-2104

Specialties & licenses 1

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

Addresses

Primary practice location

221 W First
Saint Francis, KS 67756-1075

Mailing address

221 W First
PO Box 1075
Saint Francis, KS 67756-1075
Phone (785) 332-2682

Other identifiers 3

IdentifierTypeStateIssuer
30003937290003MedicaidKS
110731OtherKSBCBS
38684748MedicaidCO

Other names 1

  • Cheyenne County 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
O20040519001000 KS Part B Supplier - Clinic/Group Practice 7517958523 Receives reassigned benefits from 28 practitioners
2 other NPIs on this enrollment
Practice locations: Bird City, KS; Saint Francis, KS; St Francis, KS
O20060404000782 KS Part A Provider - Rural Health Clinic 7517958523 Practice locations: Saint Francis, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982644936. Details of each certification follow.

Rural health clinic certification: CCN 173477

Legal name
GREAT PLAINS OF CHEYENNE CO INC
Doing business as
CHEYENNE COUNTY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 27, 1998
Last certification
Nov 12, 2013
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2002 (1 total)
Organization structure
CorporationNon-profit
Incorporated
in KS
Enrollment address
221 W 1St St
Saint Francis, KS 67756-3540
Related CCNs
171310

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

Other NPIs with the same Medicare PAC ID 4

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
17D0937887Cheyenne County Clinic St Francis221 West First Street, St Francis, KS 67756Certificate of waiverDec 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
John Terrill Individual Corporate DirectorBoard Member Sep 18, 2007 5%
William Wilger Individual Corporate DirectorBoard Member Jul 1, 2021
Ryan Murray Individual Corporate DirectorBoard Member Jul 1, 2021
Sondra Bracelin Individual Corporate DirectorBoard Member Jul 1, 2021
Teresa Moore Individual Corporate Director Jul 1, 2021
Great Plains Health Alliance Inc Organization, Phillipsburg, KS Operational/Managerial Control Jan 1, 2002
Steve L Carlson Individual Corporate OfficerChairman of the Board May 24, 1994 20%
Corporate DirectorChair of the Board May 24, 1988 20%
Barbara a Brown Applegate Individual Corporate DirectorBoard Member Sep 20, 2012 5%
Heidi Tice Individual Corporate OfficerCfo Apr 1, 1998
Operational/Managerial ControlCfo Jan 20, 2017
Arthur G Henrickson Individual Corporate DirectorBoard Member Jun 19, 2017
Leslie C Lacy Individual Corporate OfficerVice President May 19, 2014
W-2 Managing EmployeeVice President May 19, 2014
Jeremy M Clingenpeel Individual Corporate OfficerCeo Jan 30, 2023
Corporate DirectorCeo Jan 30, 2023
W-2 Managing EmployeeCeo Jan 30, 2023
Curt Colson Individual Corporate DirectorPresident of Great Plains Health Al Apr 1, 2022

Owners & managing parties with NPI records 1

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

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1982644936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W FIRST",
            "address_2": "PO BOX 1075",
            "city": "SAINT FRANCIS",
            "state": "KS",
            "postal_code": "677561075",
            "telephone_number": "785-332-2682",
            "fax_number": "785-332-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W FIRST",
            "city": "SAINT FRANCIS",
            "state": "KS",
            "postal_code": "677561075",
            "telephone_number": "785-332-2682",
            "fax_number": "785-332-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT PLAINS OF CHEYENNE CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "CLINGENPEEL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-332-2104"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003937290003",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110731",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38684748",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheyenne County Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cheyenne County Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Francis, KS

Sources for this page

Verify at the official NPI Registry.