NPIMap

Organization Active NPI

Clay County Medical Center

  • Certified Registered Nurse Anesthetist
  • Clay Center, KS
National Provider Identifier
1114961174
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
CLAY COUNTY MEDICAL CENTER
Practice address
617 Liberty St
Clay Center, KS 67432-1564
Phone
(785) 632-2144
Fax
(785) 632-3352
NPI assigned
Jun 16, 2006
Last updated
Nov 30, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CLAY COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Austin Gillard
Title
Ceo
Phone
(785) 632-2144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

617 Liberty St
Clay Center, KS 67432-1564

Mailing address

PO Box 512
Clay Center, KS 67432-0512
Phone (785) 632-2144

Other identifiers 1

IdentifierTypeStateIssuer
012081OtherKSBLUE SHIELD GROUP CRNA

National Provider Directory

National Provider Directory
Tax ID family
Clay Co Hosp Crna9 organizations share this tax ID, including this one
Part of
Clay Co Hosp Crna

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1114961174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674320512",
            "telephone_number": "785-632-2144",
            "fax_number": "785-632-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LIBERTY ST",
            "city": "CLAY CENTER",
            "state": "KS",
            "postal_code": "674321564",
            "telephone_number": "785-632-2144",
            "fax_number": "785-632-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAY COUNTY MEDICAL CENTER",
        "enumeration_date": "2006-06-16",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "GILLARD",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-632-2144"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP CRNA",
            "identifier": "012081",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clay Center, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.