NPIMap

Organization Active NPI

MH Health of Kansas, PA

  • Nurse Practitioner
  • Dodge City, KS
National Provider Identifier
1205497054
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MH HEALTH OF KANSAS, PA
Practice address
2305 Central Ave
Dodge City, KS 67801-6203
Phone
(620) 801-3320
NPI assigned
Jun 24, 2019
Last updated
Jun 24, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MH HEALTH OF KANSAS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Authorized official

Name
Nancy Carlson, MD
Title
President
Phone
(802) 857-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

2305 Central Ave
Dodge City, KS 67801-6203

Mailing address

PO Box 5
Winooski, VT 05404-0005
Phone (802) 857-0400

Other names 1

  • Marathon Health Employee Health Center at Cargill Dodge City Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2123143Marathon Health at Cargill-Dodge City2305 Central Avenue, Dodge City, KS 67801Certificate of waiverDec 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
MH Health of Kansas PA10 organizations share this tax ID, including this one
Part of
MH Health of Kansas PA

Other organizations with this tax ID 9

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

Locations

2305 Central Ave
Dodge City, KS 67801
Phone (620) 801-3320

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1205497054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054040005",
            "telephone_number": "802-857-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CENTRAL AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678016203",
            "telephone_number": "620-801-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MH HEALTH OF KANSAS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MH HEALTH OF KANSAS, PA",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-857-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marathon Health Employee Health Center at Cargill Dodge City",
            "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 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.