NPIMap

Organization Active NPI

Ottawa Family Physicians, Chartered

  • Family Medicine Physician
  • Ottawa, KS
National Provider Identifier
1023558541
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OTTAWA FAMILY PHYSICIANS, CHARTERED
Practice address
120 E 19TH St Ste a
Ottawa, KS 66067-4300
Phone
(785) 214-4903
Fax
(785) 214-4622
NPI assigned
Mar 2, 2017
Last updated
Oct 15, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
OTTAWA FAMILY PHYSICIANS, CHTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
Denise Lynn McPheron
Title
Administrator
Phone
(785) 242-1620

Specialties & licenses 1

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

Addresses

Primary practice location

120 E 19TH St Ste a
Ottawa, KS 66067-4300

Mailing address

1418 S Main St
Ste 5
Ottawa, KS 66067-3543
Phone (785) 242-1620

Other names 1

  • OTTAWA CARE CLINIC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050222000840 KS Part B Supplier - Clinic/Group Practice 7416900113 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ottawa, KS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Ottawa Family Chartered

Locations

120 E 19th St
#A
Ottawa, KS 66067
Phone (785) 214-4903

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1023558541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 S MAIN ST",
            "address_2": "STE 5",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673543",
            "telephone_number": "785-242-1620",
            "fax_number": "785-242-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 19TH ST STE A",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660674300",
            "telephone_number": "785-214-4903",
            "fax_number": "785-214-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTAWA FAMILY PHYSICIANS, CHARTERED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OTTAWA FAMILY PHYSICIANS, CHTD.",
        "enumeration_date": "2017-03-02",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "MCPHERON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-242-1620"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OTTAWA CARE CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ottawa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.