NPIMap

Organization Active NPI

Coffey County Hospital

Doing business as Coffey Counth Hospital Home Health Agency

  • Clinic/Center
  • Waverly, KS
National Provider Identifier
1013905405
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COFFEY COUNTY HOSPITAL
Doing business as
Coffey Counth Hospital Home Health Agency
Practice address
302 Pearson Ave
Waverly, KS 66871-9676
Phone
(785) 733-2667
NPI assigned
Oct 10, 2005
Last updated
Jan 15, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COFFEY COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Merri Michaels
Title
Billing Supervisor
Phone
(620) 364-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

302 Pearson Ave
Waverly, KS 66871-9676

Mailing address

801 N 4TH St
P.O. Box 189
Burlington, KS 66839-2602
Phone (620) 364-2121

Other practice location 1

801 N 4th St
Burlington, KS 66839-2602
Phone (620) 364-2121

Other identifiers 2

IdentifierTypeStateIssuer
100098820BMedicaidKS
180038OtherKSBLUE CROSS BLUE SHIELD

Other names 1

  • Coffey Counth Hospital Home Health Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coffey Co Hosp Amb9 organizations share this tax ID, including this one
Part of
Lyndon Medical Center

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1013905405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N 4TH ST",
            "address_2": "P.O. BOX 189",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668392602",
            "telephone_number": "620-364-2121",
            "fax_number": "620-364-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PEARSON AVE",
            "city": "WAVERLY",
            "state": "KS",
            "postal_code": "668719676",
            "telephone_number": "785-733-2667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "KS",
            "postal_code": "668392602",
            "country_code": "US",
            "telephone_number": "620-364-2121",
            "fax_number": "620-364-8425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COFFEY COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COFFEY COUNTY MEDICAL CENTER",
        "enumeration_date": "2005-10-10",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "MERRI",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "620-364-2121"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098820B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "180038",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coffey Counth Hospital Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.