NPIMap

Organization Active NPI

Commonspirit Kansas, Inc.

  • Internal Medicine Physician
  • Dodge City, KS
National Provider Identifier
1194438713
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMONSPIRIT KANSAS, INC.
Practice address
2300 N 14TH Ave Ste 104
Dodge City, KS 67801-2367
Phone
(620) 371-7010
Fax
(620) 371-7011
NPI assigned
Dec 28, 2022
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Mrs. Angela Jo Skinner
Title
Administrator
Phone
(720) 667-7283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2300 N 14TH Ave Ste 104
Dodge City, KS 67801-2367

Mailing address

PO Box 803929
Kansas City, MO 64180-3929
Phone (888) 347-3295

Other identifiers 1

IdentifierTypeStateIssuer
30003913010026MedicaidKS

Other names 4

  • St Catherine Hospital Former legal business name
  • CommonSpirit Internal Medicine Dodge City Other name
  • Internal Medicine Dodge City Other name
  • SCDC INTERNAL MED Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050302000707 KS Part B Supplier - Clinic/Group Practice 4789595844 Receives reassigned benefits from 87 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cimarron, KS; Ulysses, KS; Liberal, KS; Garden City, KS; Dodge City, KS

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Tax ID family
St Catherine Hosp Lab27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1194438713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803929",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641803929",
            "telephone_number": "888-347-3295",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N 14TH AVE STE 104",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012367",
            "telephone_number": "620-371-7010",
            "fax_number": "620-371-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONSPIRIT KANSAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "720-667-7283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003913010026",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Catherine Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CommonSpirit Internal Medicine Dodge City",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Internal Medicine Dodge City",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SCDC INTERNAL MED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.