COMMUNITY HEALTHCARE SYSTEM, INC (NPI# 1821063249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821063249 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTHCARE SYSTEM, INC |
| Other Organization Name | EASTRIDGE |
| Practice Address |
604 1st St Centralia KS 66415-9637 |
| Practice Telephone | 7858573388 |
| Practice Fax Number | 7858573349 |
| Mailing Telephone | 7858573388 |
| Mailing Fax Number | 7858573349 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | MR. TODD M WILLERT (CEO) |
| Authorized Official Telephone | 7858895002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
N066006 | KS | Ambulatory Health Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | N066006 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100111800A | 05 | |
| KS | BLUE CROSS BLUE SHIELD | 001247 | 01 |
| Other Name | Type Code |
|---|---|
| Eastridge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003108440 | Community Healthcare System, Inc | Family Medicine | 6221 5th Street, Corning, KS 66417 | 2011-05-04 |
| 1366407744 | Community Healthcare System, Inc | Home Health | 100 W 8th St, Onaga, KS 66521-9574 | 2006-04-19 |
| 1972578243 | Community Healthcare System, Inc | Assisted Living Facility | 205 W 9th St, Onaga, KS 66521-9625 | 2006-02-21 |
| 1275504839 | Community Healthcare System, Inc | Clinic/Center | 206 Grand Ave, St Marys, KS 66536-1637 | 2006-01-31 |
| 1891766887 | Community Healthcare System, Inc | Clinic/Center | 112 East 2nd, Frankfort, KS 66427-1402 | 2006-01-30 |
| 1457351389 | Community Healthcare System, Inc | Pharmacy | 120 W 8th St, Onaga, KS 66521-9574 | 2005-07-21 |
| 1255635876 | Community Healthcare System, Inc | Family Medicine | 302 Main St, Westmoreland, KS 66549-9684 | 2010-12-23 |
| 1134185119 | Community Healthcare System, Inc | Home Health | 100 W 8th St, Onaga, KS 66521-9574 | 2006-04-26 |
| 1093771776 | Community Healthcare System, Inc | Family Medicine | 120 W 8th St, Onaga, KS 66521-9574 | 2006-04-21 |
| 1811952138 | Community Healthcare System, Inc | Durable Medical Equipment & Medical Supplies | 120 W 8th St, Onaga, KS 66521-9574 | 2006-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY HEALTHCARE SYSTEM, INC. | 120 West 8th St, Onaga, KS 66521-9574 |
| Indiana Business Entities | COMMUNITY HEALTHCARE SYSTEM, INC. | 300 E. 90th Dr., `, Merrillville, IN 46410 |
| Street Address |
604 1ST ST |
| City | CENTRALIA |
| State | KS |
| Zip Code | 66415-9637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366005316 | Kylar G Meyer | Occupational Therapist | 604 1st St, Centralia, KS 66415-9637 | 2019-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295704054 | City of Centralia | Ambulance | 708 Second St, Centralia, KS 66415-0247 | 2006-03-15 |
| 1225008345 | Amy L Jones | Family Medicine | 606 1st St, Centralia, KS 66415-9637 | 2006-01-23 |
| 1699747279 | Community Healthcare System, Inc | Clinic/Center | 606 1st St, Centralia, KS 66415-9637 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427715 | Jerald Rodman | Social Worker | 2565 Kristine Ct, Centralia, WA 98531-8808 | 2020-11-02 |
| 1790385821 | Joshua Bigner | Counselor | 201 S Tower Ave Apt E2, Centralia, WA 98531-4055 | 2020-10-28 |
| 1407463706 | Allison Nichole Kemble | Social Worker | 806 Shawn Ct, Centralia, MO 65240-4320 | 2020-09-30 |
| 1356955249 | Olympia Respiratory Services LLC | Durable Medical Equipment & Medical Supplies | 333 Fair St, Centralia, WA 98531-8906 | 2020-09-08 |
| 1912515917 | N W Pediatric Center, Inc. P.s. | Counselor | 1915 Cooks Hill Rd, Centralia, WA 98531-9073 | 2020-07-16 |
| 1174149447 | Mcp Cooks Hill Wa Opco LLC | Assisted Living Facility | 2010 Cooks Hill Rd, Centralia, WA 98531-8832 | 2020-06-22 |
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205469103 | Vicki Lee Lucht | Licensed Practical Nurse | 3510 Steelhammer Dr # 3, Centralia, WA 98531-4551 | 2020-02-19 |
| 1881224228 | Tailored Made Hair Replacement Center LLC | Specialist | 201 W Switzler St Ste B, Centralia, MO 65240-1594 | 2020-01-24 |
| 1518505981 | Zachery E Hanke I | Counselor | 2428 W Reynolds Ave Ofc 185, Centralia, WA 98531-4554 | 2019-12-17 |
| Find all providers in CENTRALIA | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568748317 | Friendship-ltc, LLC | Skilled Nursing Facility | 1000 Martin Luther King Dr, Centralia, IL 62801-3002 | 2011-10-25 |
| 1962435941 | Ltc Illinois - Friendship, Inc. | Skilled Nursing Facility | 1000 Martin Luther King, Centralia, IL 62801 | 2006-07-10 |
| 1700819778 | Ltc of Illinois - Fireside, Inc. | Skilled Nursing Facility | 1030 Martin Luther King Dr, Centralia, IL 62801-3002 | 2006-07-10 |
| 1194763565 | Sharon Care Center, Inc | Skilled Nursing Facility | 1509 Harrison Ave, Centralia, WA 98531-4568 | 2006-06-04 |
| 1245227131 | Northwest Country Place, Inc | Skilled Nursing Facility | 917 S Scheuber Rd, Centralia, WA 98531-9027 | 2005-10-05 |
| 1689660961 | Unlimited Development Inc. | Skilled Nursing Facility | 1910 E Mccord, Centralia, IL 62801-6586 | 2005-09-22 |
| 1942295993 | Evergreen Washington Healthcare Centralia, L.L.C. | Skilled Nursing Facility | 1015 Long Rd, Centralia, WA 98531-1038 | 2005-09-15 |
| 1154328953 | Health Services Administration, Inc | Skilled Nursing Facility | 750 E Highway 22, Centralia, MO 65240-1146 | 2005-07-07 |
| 1861977019 | Hcc-healthcare Properties, LLC | Skilled Nursing Facility | 1030 Martin Luther King Dr, Centralia, IL 62801-3002 | 2018-10-03 |
| 1134632961 | Riverside Nursing - Centralia LLC | Skilled Nursing Facility | 1305 Alexander St, Centralia, WA 98531-1305 | 2017-11-15 |
| Find all providers in CENTRALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.