County of Montgomery
Organization Active NPI Public Health or Welfare Agency · Coffeyville, KS
NPI 1124126073 · NPPES record last updated Mar 2, 2018
Key facts
- NPI
- 1124126073
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- COUNTY OF MONTGOMERY
- Practice address
- 908 Walnut St
Coffeyville, KS 67337-5827 - Phone
- (620) 251-4210
- Fax
- (620) 251-6708
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Carolyn Marie Muller
- Title
- Administrator
- Phone
- (620) 251-4210
Practitioners 7
-
Linsey Jackman, PHYSICIAN ASSISTANT
-
Jo A Kinzie, RDH
-
Sherry L. Martell, APRN
-
Hannah L Nolte, RDH
-
Geeta Sandhu, M.D.
-
Patricia R Thompson, APRN
-
Aaron D Dahle, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130715000619 | KS | Part B Supplier - Mass Immunization (Roster Biller Only) | 0244249753 | Practice locations: Coffeyville, KS |
National Provider Directory
Locations
604 Union St
Coffeyville, KS 67337
Phone (620) 251-4210
908 Walnut St
Coffeyville, KS 67337
Phone (620) 251-4210
217 E Myrtle St
Independence, KS 67301
Phone (620) 331-4300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | KS | Yes |
Addresses
Primary practice location
908 Walnut St
Coffeyville, KS 67337-5827
Mailing address
908 Walnut St
Coffeyville, KS 67337-5827
Phone (620) 251-4210
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100297640A | Medicaid | DE | |
| 47163 | Other | KS | BCBS OF KANSAS |
| 100297640B | Medicaid | KS |
Other names
- Montgomery County Health Department
Other providers in Coffeyville, KS
- Community Health Center of Southeast Kansas, Inc
- Community Health Center of Southeast Kansas, Inc.
- Jon W. Conrad
- Alan Duane Conrady
- Timothy Cosgrove
- Cynthia Marie Dale
- Tina Daniel
- David C. Bumgarner, D.C., P.a.
- Antwanette Davis
- Savana Debo
All providers in Coffeyville, KS · Public Health or Welfare Agency in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2018. 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.