NPIMap

Organization Active NPI

Digestive Health Center of the Four States, LLC

  • Gastroenterology Physician
  • Galena, KS
National Provider Identifier
1053754986
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE HEALTH CENTER OF THE FOUR STATES, LLC
Practice address
198 Four States Dr
Suite 6
Galena, KS 66739-4304
Phone
(620) 783-1650
Fax
(620) 783-1652
NPI assigned
Apr 10, 2013
Last updated
Apr 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Allan P Weston, MDNPI 1417051962
Title
Owner, MD
Phone
(620) 783-1650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

Addresses

Primary practice location

198 Four States Dr
Suite 6
Galena, KS 66739-4304

Mailing address

198 Four States Dr
Suite 6
Galena, KS 66739-4304
Phone (620) 783-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130711000599 MO Part B Supplier - Clinic/Group Practice 7719127901 Receives reassigned benefits from 1 practitioner
Practice locations: Joplin, MO
O20130815000444 KS Part B Supplier - Clinic/Group Practice 7719127901 Receives reassigned benefits from 1 practitioner
Practice locations: Galena, KS

National Provider Directory

National Provider Directory

Locations

198 Four States Dr
Ste 6
Galena, KS 66739
Phone (620) 783-1650

2615 E 20th St
Joplin, MO 64804
Phone (417) 624-4701

Practitioners & affiliated clinicians

Practitioners 9

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": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1053754986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 FOUR STATES DR",
            "address_2": "SUITE 6",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394304",
            "telephone_number": "620-783-1650",
            "fax_number": "620-783-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 FOUR STATES DR",
            "address_2": "SUITE 6",
            "city": "GALENA",
            "state": "KS",
            "postal_code": "667394304",
            "telephone_number": "620-783-1650",
            "fax_number": "620-783-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH CENTER OF THE FOUR STATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "WESTON",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER, MD",
        "authorized_official_telephone_number": "620-783-1650",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.