Individual provider Active NPI

Kent A Coltharp, DO

  • Family Medicine Physician
  • Pittsburg, KS
National Provider Identifier
1093834723
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-22102 Issued in KS
Practice address
3011 N Michigan St
Pittsburg, KS 66762-2546
Phone
(888) 777-9170
Fax
(620) 231-5062
NPI assigned
Mar 27, 2007
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05-22102 KS Primary

Addresses

Primary practice location

3011 N Michigan St
Pittsburg, KS 66762-2546

Mailing address

PO Box 1832
Pittsburg, KS 66762-1832
Phone (888) 777-9170

Other identifiers 1

IdentifierTypeStateIssuer
100237150BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05-22102KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Family Medicine Past Accepting new patients
Sjmgroup Past Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kent.coltharp@khindirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1093834723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832",
            "telephone_number": "888-777-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 N MICHIGAN ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622546",
            "telephone_number": "888-777-9170",
            "fax_number": "620-231-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTHARP",
        "first_name": "KENT",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-22102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100237150B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.