NPIMap

Organization Active NPI

Community Healthcare System, Inc

Doing business as Corning Clinic

  • Family Medicine Physician
  • Corning, KS
National Provider Identifier
1003108440
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H075001 Issued in KS
Legal business name
COMMUNITY HEALTHCARE SYSTEM, INC
Doing business as
Corning Clinic
Practice address
6221 5TH Street
Corning, KS 66417
Phone
(785) 857-3334
Fax
(785) 857-3397
NPI assigned
May 4, 2011
Last updated
Aug 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Authorized official

Name
Mr. Todd M Willert
Title
Ceo
Phone
(785) 889-5002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X H075001 KS Primary

Addresses

Primary practice location

6221 5TH Street
Corning, KS 66417

Mailing address

6221 5TH Street
Corning, KS 66417
Phone (785) 857-3334

Other names 1

  • Corning Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rural Health Clinic17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5d5c0d2d-0eb7-48af-8536-161bb1a08f58/

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1003108440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 5TH STREET",
            "city": "CORNING",
            "state": "KS",
            "postal_code": "66417",
            "telephone_number": "785-857-3334",
            "fax_number": "785-857-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 5TH STREET",
            "city": "CORNING",
            "state": "KS",
            "postal_code": "66417",
            "telephone_number": "785-857-3334",
            "fax_number": "785-857-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "WILLERT",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-889-5002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "H075001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corning Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Corning Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corning, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.