Individual provider Active NPI

Christopher S Patton, D.D.S, P.A.

  • General Practice Dentistry
  • Phillipsburg, KS
National Provider Identifier
1104912047
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6851 Issued in KS
Practice address
730 4TH St
Phillipsburg, KS 67661-1916
Phone
(785) 543-5123
Fax
(785) 543-2803
NPI assigned
Oct 5, 2006
Last updated
Feb 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6851 KS Primary

Addresses

Primary practice location

730 4TH St
Phillipsburg, KS 67661-1916

Mailing address

730 4TH St
Phillipsburg, KS 67661-1916
Phone (785) 543-5123

Other identifiers 2

IdentifierTypeStateIssuer
100225640BMedicaidKS
19087OtherKSBLUE CROSS BLUE SHIELD-KS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608001068 KS Order and Referring Only - DentistPractitioner - Dentist 0042531683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6851KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher S. Patton, D.D.S., P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1104912047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 4TH ST",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676611916",
            "telephone_number": "785-543-5123",
            "fax_number": "785-543-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 4TH ST",
            "city": "PHILLIPSBURG",
            "state": "KS",
            "postal_code": "676611916",
            "telephone_number": "785-543-5123",
            "fax_number": "785-543-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "credential": "D.D.S,  P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225640B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-KS",
            "identifier": "19087",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, KS

Sources for this page

Verify at the official NPI Registry.