NPIMap

Organization Active NPI

Lindsborg Community Hospital Association

Doing business as Lindsborg Community Hospital Clinic

  • Family Medicine Physician
  • Great Bend, KS
National Provider Identifier
1144770298
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H-059-001 Issued in KS
Legal business name
LINDSBORG COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Lindsborg Community Hospital Clinic
Practice address
3715 10TH St
Great Bend, KS 67530-3542
Phone
(620) 792-7868
NPI assigned
Oct 12, 2016
Last updated
Jan 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
LINDSBORG COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Authorized official

Name
Larry Van Der Wege
Title
Administrator
Phone
(785) 227-3308

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H-059-001 KS
Family Medicine Physician 207Q00000X H-059-001 KS Primary

Addresses

Primary practice location

3715 10TH St
Great Bend, KS 67530-3542

Mailing address

605 W Lincoln St
Lindsborg, KS 67456-2328
Phone (785) 227-3308

Other identifiers 1

IdentifierTypeStateIssuer
016774OtherKSMEDICARE ID - TYPE UNSPECIFIED

Other names 1

  • Lindsborg Community Hospital Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050223000687 KS Part B Supplier - Clinic/Group Practice 3971556580 Receives reassigned benefits from 66 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lindsborg, KS; Marquette, KS

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Lindsborg Comm Association

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1144770298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W LINCOLN ST",
            "city": "LINDSBORG",
            "state": "KS",
            "postal_code": "674562328",
            "telephone_number": "785-227-3308",
            "fax_number": "785-227-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 10TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303542",
            "telephone_number": "620-792-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDSBORG COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINDSBORG COMMUNITY HOSPITAL",
        "enumeration_date": "2016-10-12",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "VAN DER WEGE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-227-3308"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "KS",
            "license": "H-059-001",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "H-059-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "016774",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lindsborg Community Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.