Hunter Health Clinic, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

HUNTER HEALTH CLINIC, INC

Practice address

2750 S Roosevelt St
Wichita, KS 67210-1304

Phone

(316) 652-0152

Fax

(316) 652-0928

NPI assigned

Nov 27, 2006

Organization subpart

Yes

Parent organization

1376618348As reported in NPPES

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

Authorized official

Name

Ronald Saal

Title

Cfo

Phone

(316) 262-2415

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Hunter Health Clinic at Brookside Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 171828

Legal name

HUNTER HEALTH CLINIC INC

Doing business as

HUNTER HEALTH CLINIC AT BROOKSIDE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 22, 2009

Last certification

Jan 22, 2009

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 4, 1980 in KS

Enrollment address

2750 S Roosevelt St
Wichita, KS 67210-1304

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Hunter Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1376618348

  5193632941

  Same PAC ID
• Hunter Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1174690796

  5193632941

  Same PAC ID

Other NPIs on the same Medicare enrollment 5

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

• Hunter Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1376618348

  O20040220001001

  Same enrollment
• Hunter Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1174690796

  O20040220001001

  Same enrollment
• Hunter Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1265508337

  O20040220001001

  Same enrollment
• Hunter Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1396809547

  O20040220001001

  Same enrollment
• Hunter Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1841759453

  O20040220001001

  Same enrollment

Part of

Hunter Health Clinic Inc

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FECIBD

All disclosed owners & managing parties 14

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

Practitioners 2

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

• Hannah Joy Landenberger, PA

  • Physician Assistant
  • Wichita, KS
  • NPI 1962244954
  NPD
• Callie Jo Wentling, PA-C

  • Medical Physician Assistant
  • Wichita, KS
  • NPI 1154670354
  NPD

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1053487579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 E CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144436",
            "telephone_number": "316-262-2415",
            "fax_number": "316-262-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S ROOSEVELT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101304",
            "telephone_number": "316-652-0152",
            "fax_number": "316-652-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTER HEALTH CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1376618348",
        "enumeration_date": "2006-11-27",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "SAAL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "316-262-2415"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "003947",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100212200C",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hunterhealth@khindirect.org",
            "affiliation": "N",
            "endpointDescription": "Facility",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2750 S Roosevelt St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672101304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hunter Health Clinic at Brookside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane L.S. Hunt, MD
• Staci Hunt, COUNSELOR ASS.
• Travis James Hunt
• Hunter Health Clinic Inc
• Hunter Health Clinic Inc
• Hunter Health Clinic, Inc
• Hunter Health Clinic, Inc
• Hunter Health Clinic, Inc
• Hunter Health Clinic, Inc
• Hunter Health Clinic, Inc

• Federally Qualified Health Center (FQHC) in Wichita, KS
• Providers in Wichita, KS by specialty
• Federally Qualified Health Center (FQHC) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.