Community Memorial Healthcare, Inc.
Organization Active NPI Rural Health Clinic/Center · Marysville, KS
NPI 1124049937 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1124049937
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- COMMUNITY MEMORIAL HEALTHCARE, INC.
- Practice address
- 808 N 19TH St
Marysville, KS 66508-1358 - Phone
- (785) 562-2303
- Fax
- (785) 562-2034
- NPI assigned
- Jul 21, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMUNITY MEMORIAL HEALTHCARE, INC
Authorized official
- Name
- Therese M Landoll
- Title
- Cfo
- Phone
- (785) 562-2311
Other NPIs on the same Medicare enrollment 5
Practitioners 12
-
Kenneth L Duensing, D.O.
-
Julia M Hammett, ARNP
-
Jason A Hampl, M.D.
-
Rebecca Ann Heuer, A.P.R.N.
-
Dayna K Scheele, ARNP
-
Shane E. Thoreson, M.D.
-
Jennifer E White-Slough, APRN
-
Abigail L Kidwell, ARNP
-
Kirk Martin, PAC
-
Becky Marlene Saathoff, P.A.
-
Michelle A Stone, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040304000181 | KS | Part B Supplier - Clinic/Group Practice | 6608763503 |
Receives reassigned benefits from 14 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marysville, KS; Axtell, KS; Blue Rapids, KS |
National Provider Directory
- Part of
- Community Physicians CL
Locations
808 N 19th St
Marysville, KS 66508
Phone (785) 562-2303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
808 N 19TH St
Marysville, KS 66508-1358
Mailing address
808 N 19TH St
Marysville, KS 66508-1358
Phone (785) 562-2303
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CD1965 | Other | RAILROAD MEDICARE | |
| 110007 | Other | KS | BLUE CROSS/BLUE SHIELD KS |
Other names
- Marysville Clinic
Other providers in Marysville, KS
- Susanne Cashier
- Mercy Chepleting
- Community Healthcare System, Inc
- Community Memorial Healthcare, Inc
- Community Memorial Healthcare, Inc.
- Community Memorial Healthcare, Inc.
- Community Memorial Healthcare, Inc.
- Community Memorial Healthcare, Inc.
- Community Memorial Healthcare, Inc.
- Community Memorial Healthcare, Inc.
All providers in Marysville, KS · Rural Health Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.