Provider Demographics
NPI:1417030123
Name:DUNDY COUNTY HOSPITAL
Entity Type:Organization
Organization Name:DUNDY COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-423-2204
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:BENKELMAN
Mailing Address - State:NE
Mailing Address - Zip Code:69021-0710
Mailing Address - Country:US
Mailing Address - Phone:308-423-2670
Mailing Address - Fax:308-423-2209
Practice Address - Street 1:1313 N CHEYENNE ST
Practice Address - Street 2:
Practice Address - City:BENKELMAN
Practice Address - State:NE
Practice Address - Zip Code:69021-3074
Practice Address - Country:US
Practice Address - Phone:308-423-2204
Practice Address - Fax:308-423-5691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUNDY COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid
NE=========MedicaidSTRATTON NON-RHC PROF SVC
NE03512OtherCLINIC-BCBS OF NE
NE04253OtherHOSP PROF SVC-BCBS OF NE
NE=========MedicaidER PROF SVCS
NECH5949OtherRR MEDICARE
NE36485OtherCRNA-BCBS OF NE
NE=========MedicaidNON-RHC PROF SVCS
NE=========13Medicaid
NE=========01MedicaidNON-RHC PROF SVCS
NE=========13MedicaidSTRATTON NON-RHC PROF SVC