NPIMap

Organization Active NPI

Central Kansas Medical Center

  • Family Medicine Physician
  • Great Bend, KS
National Provider Identifier
1043556400
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL KANSAS MEDICAL CENTER
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 272-2514
NPI assigned
Dec 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Amanda R Vaughan
Title
Cfo
Phone
(620) 272-2561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X KS Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

PO Box 960462
Oklahoma City, OK 73196-0462
Phone (877) 485-4474

Other names 1

  • ST ROSE FAMILY MEDICINE & URGENT CARE CLINIC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1043556400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960462",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960462",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-272-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL KANSAS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-272-2561"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ROSE FAMILY MEDICINE & URGENT CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.