Pheasant Ridge Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHEASANT RIDGE FAMILY MEDICINE, LLC

Practice address

312 S Maple St
Garnett, KS 66032-1333

Phone

(785) 787-5050

NPI assigned

Nov 16, 2019

Last updated

Nov 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ross Kimball, MDNPI 1982876512

Title

Physician

Phone

(785) 787-5050

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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.

• Ross M Kimball, MD

  • Family Medicine Physician
  • Garnett, KS
  • NPI 1982876512
  Authorized official Same address or phone

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573862400000",
    "number": "1023653789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S MAPLE ST",
            "city": "GARNETT",
            "state": "KS",
            "postal_code": "660321333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S MAPLE ST",
            "city": "GARNETT",
            "state": "KS",
            "postal_code": "660321333",
            "telephone_number": "785-787-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHEASANT RIDGE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "785-787-5050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EMR",
            "affiliation": "N",
            "address_1": "312 S Maple St",
            "city": "Garnett",
            "state": "KS",
            "country_code": "US",
            "postal_code": "660321333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah M. Nuessen, PA-C
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• Mackenzie Peterson, M.D.
• Janea Louise Poe, RD
• Megan Elizabeth Pyle, COTA
• Regional Healthcare LLC
• Donna Sue Rockers, PHARMD
• Jeanette Rogers, T-LMLP

• Family Medicine Physician in Garnett, KS
• Providers in Garnett, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.