NPIMap

Organization Active NPI

Satanta District Hospital and Long-Term Care

Doing business as Satanta District Hospital Clinic - Non Rural Health

  • Family Medicine Physician
  • Satanta, KS
National Provider Identifier
1144312844
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H041001 Issued in KS
Legal business name
SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE
Doing business as
Satanta District Hospital Clinic - Non Rural Health
Practice address
410 Cheyenne Street
Satanta, KS 67870-0009
Phone
(620) 649-2771
Fax
(620) 649-2538
NPI assigned
Sep 29, 2006
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SATANTA DISTRICT HOSPITAL AND LONG-TERM CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Tina Pendergraft
Title
Administrator
Phone
(620) 649-2761

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H041001 KS Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

410 Cheyenne Street
Satanta, KS 67870-0009

Mailing address

PO Box 9
Satanta, KS 67870-0009
Phone (620) 649-2771

Other identifiers 1

IdentifierTypeStateIssuer
110220OtherKSNON RURAL HEALTH NUMBER

Other names 1

  • Satanta District Hospital Clinic - Non Rural Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001369 KS Part B Supplier - Clinic/Group Practice 5991616054 Receives reassigned benefits from 15 practitioners
2 other NPIs on this enrollment
Practice locations: Elkhart, KS; Satanta, KS; Sublette, KS

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Satanta Hosp Long Term Care

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Satanta District HospitalSatanta, KS, CCN 171324 Hospital Operational/Managerial Control Dec 15, 1983
Satanta District Hospital Clinic SatantaSatanta, KS, CCN 173455 Rural health clinic Operational/Managerial Control Feb 10, 2015
Satanta District Hospital Clinic-SubletteSublette, KS, CCN 173454 Rural health clinic Operational/Managerial Control (100%) Aug 23, 2007

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1144312844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "SATANTA",
            "state": "KS",
            "postal_code": "678700009",
            "telephone_number": "620-649-2771",
            "fax_number": "620-649-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHEYENNE STREET",
            "city": "SATANTA",
            "state": "KS",
            "postal_code": "678700009",
            "telephone_number": "620-649-2771",
            "fax_number": "620-649-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATANTA DISTRICT HOSPITAL AND LONG-TERM CARE",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "PENDERGRAFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-649-2761"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "H041001",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON RURAL HEALTH NUMBER",
            "identifier": "110220",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satanta District Hospital Clinic - Non Rural Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Satanta District Hospital Clinic - Non Rural Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Satanta, KS

Sources for this page

Verify at the official NPI Registry.