County of Leavenworth

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

COUNTY OF LEAVENWORTH

Practice address

500 Eisenhower Rd.
Suite 101
Leavenworth, KS 66048-4969

Phone

(913) 250-2000

Fax

(913) 250-2039

NPI assigned

Jul 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jamie A. Miller

Title

Director Health Department

Phone

(913) 250-2006

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• dba Leavenworth County Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• County of Leavenworth

  • Ambulance
  • Leavenworth, KS
  • NPI 1972606580

  9739126533

  Same PAC ID

Tax ID family

Leavenworth Co Skilled2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• County of Leavenworth

  • Ambulance
  • Leavenworth, KS
  • NPI 1972606580
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sara Beaudry, MPH, BSN, RN, CHES

  • Registered Nurse
  • Leavenworth, KS
  • NPI 1578244158
  NPD (past)
• Violet A Gomes, DNP, APRN, NP-C

  • Nurse Practitioner
  • Leavenworth, KS
  • NPI 1609407477
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364515200000",
    "number": "1174540256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EISENHOWER RD.",
            "address_2": "SUITE 101",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484969",
            "telephone_number": "913-250-2000",
            "fax_number": "913-250-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EISENHOWER RD.",
            "address_2": "SUITE 101",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484969",
            "telephone_number": "913-250-2000",
            "fax_number": "913-250-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LEAVENWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-03-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR HEALTH DEPARTMENT",
        "authorized_official_telephone_number": "913-250-2006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630050",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091480A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Leavenworth County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melinda Convey
• Linn Arthur Cooper, R.P.T.
• Jeffrey Scott Copeland, MSN ARNP
• Kaitlyn Corbin
• Phyllis Correll, CCC-SLP
• County of Leavenworth
• Janelle Rene' Cowley, MSN
• Tracy S Cowman, AU.D., CCC-A
• Tammy Louise Cox, RRT
• Christinia Elaine Craig

• State or Local Public Health Clinic/Center in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• State or Local Public Health Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.