Commonspirit Kansas, Inc.
Organization Active NPI Internal Medicine Physician · Dodge City, KS
NPI 1194438713 · NPPES record last updated Jun 5, 2025
Key facts
- NPI
- 1194438713
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Angela Jo Skinner
- Title
- Administrator
- Phone
- (720) 667-7283
Other NPIs on the same Medicare enrollment 26
Corporate family (same tax ID) 26
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- St Catherine Home HLTH
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30003913010026 | Medicaid | KS |
Other names
- St Catherine Hospital
- CommonSpirit Internal Medicine Dodge City
- Internal Medicine Dodge City
- SCDC INTERNAL MED
Other providers in Dodge City, KS
- Kimberly R. Coast
- Janet Joy Cochran
- Marie Anet Coffin
- Melissa Nicole Cole
- Callista Elizabeth Collins
- Commonspirit Kansas, Inc.
- Commonspirit Kansas, Inc.
- Commonspirit Kansas, Inc.
- Commonspirit Kansas, Inc.
- Commonspirit Kansas, Inc.
All providers in Dodge City, KS · Internal Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2025. 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.