Community Health Center of Southeast Kansas, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.

Practice address

7 S 1St St
Wyandotte, OK 74370-2268

Phone

(620) 231-9873

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Authorized official

Name

Daniel Spencer Creitz

Title

General Counsel

Phone

(620) 240-5015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Federally qualified health center certification: CCN 371946

Legal name

COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS INC

Doing business as

CHC/OK WYANDOTTE CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 24, 2019

Last certification

Sep 24, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 20, 2001 in KS

Enrollment address

7 S 1St St
Wyandotte, OK 74370-2268

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Community Health Center of Southeast Kanas Inc43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bartlesville, OK
  • NPI 1811803190
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Community/Retail Pharmacy
  • Parsons, KS
  • NPI 1134937238
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Community/Retail Pharmacy
  • Coffeyville, KS
  • NPI 1144007030
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Community/Retail Pharmacy
  • Pittsburg, KS
  • NPI 1265278352
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1447229331
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Community/Retail Pharmacy
  • Fort Scott, KS
  • NPI 1639642820
  NPD tax ID
• Community Health Center of Southeast Kanas, Inc.

  • Specialty Pharmacy
  • Pittsburg, KS
  • NPI 1922844018
  NPD tax ID
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, KS
  • NPI 1417656166
  NPD tax ID
• Community Health Center of Southeast Kansas Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Iola, KS
  • NPI 1427757673
  NPD tax ID
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086
  NPD tax ID
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Coffeyville, KS
  • NPI 1649557281
  NPD tax ID
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Chanute, KS
  • NPI 1689346793
  NPD tax ID

All disclosed owners & managing parties 15

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

All facility ownership & control disclosures 19

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald M Holsinger, M.D.

  • Internal Medicine Physician
  • Pittsburg, KS
  • NPI 1093855421
  NPD (past)

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1013567940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 N MICHIGAN ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622546",
            "telephone_number": "620-231-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S 1ST ST",
            "city": "WYANDOTTE",
            "state": "OK",
            "postal_code": "743702268",
            "telephone_number": "620-231-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "CREITZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "620-240-5015"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Ray Baron, PTA
• Laci D Barton, APRN-CNP
• Paula Boettler, PHARM D.
• Jamie Teata Davis
• Erin Downing, LPC CANDIDATE
• Destaney Dawn Dugan, PRSS
• Amber Renea Dunegan, LCSW
• Ashley Nicole Hart, MS, LPC

• Federally Qualified Health Center (FQHC) in Wyandotte, OK
• Providers in Wyandotte, OK by specialty
• Federally Qualified Health Center (FQHC) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.