NPIMap

Organization Active NPI

Labette County Medical Center

Doing business as Labette Health Pittsburg Clinic

  • Rural Health Clinic/Center
  • Pittsburg, KS
National Provider Identifier
1205524113
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LABETTE COUNTY MEDICAL CENTER
Doing business as
Labette Health Pittsburg Clinic
Practice address
2309 S Tucker Ter
Pittsburg, KS 66762-6645
Phone
(620) 291-1101
Fax
(877) 490-6696
NPI assigned
Apr 27, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LABETTE COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Thomas L Macaronas
Title
Cfo / VP
Phone
(620) 820-5251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2309 S Tucker Ter
Pittsburg, KS 66762-6645

Mailing address

PO Box 736
Parsons, KS 67357-0736
Phone (620) 820-5889

Other names 1

  • Labette Health Pittsburg Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230929002610 KS Part A Provider - Rural Health Clinic 5496664369 Practice locations: Pittsburg, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205524113. Details of each certification follow.

Rural health clinic certification: CCN 178651

Legal name
LABETTE COUNTY MEDICAL CENTER
Doing business as
LABETTE HEALTH PITTSBURG CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 20, 2023
Last certification
Dec 20, 2023
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
2309 S Tucker Ter
Pittsburg, KS 66762-6645
Related CCNs
170120

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Labette County Med Center20 organizations share this tax ID, including this one
Part of
Labette County Med Center

Other organizations with this tax ID 19

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

View all 19

Locations

405 S Huston St
Altamont, KS 67330
Phone (620) 784-5318

209 E Laurel St
Independence, KS 67301
Phone (620) 577-4310

510 Peter Pan Rd
Ste A
Independence, KS 67301
Phone (620) 332-2000

200 Carroll St
Saint Paul, KS 66771
Phone (620) 449-2582

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marna George Individual Corporate DirectorBoard Secretary Apr 21, 2003 10%
Delyna R Bohnenblust Individual Corporate DirectorBoard Vice Chair Jun 28, 2012 10%
Jill Thomas Individual Corporate DirectorBoard Member Feb 4, 2015 10%
Wayne R Gilmore Individual Corporate DirectorBoard Member Apr 25, 2013 10%
Ned Wall Individual Corporate DirectorBoard Member May 21, 2009 10%
Labette County Medical Center Organization, Parsons, KS Non-profit 5% Or Greater Direct Ownership Interest May 22, 2023 100%
Melissa Morris Individual Corporate DirectorBoard Treasurer Apr 25, 2013 10%
Perry Sorrell Individual Corporate DirectorBoard Chair Sep 11, 2003 10%
Robert Gibbs Individual Corporate DirectorBoard Member Apr 25, 2013 10%
Manish G Dixit Individual Corporate DirectorBoard Member Jan 4, 2018 10%
Thomas L. Macaronas Individual Corporate OfficerCfo Jul 12, 2004 5%
W-2 Managing Employee Jul 12, 2004 5%

Owners & managing parties with NPI records 17

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 17

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Labette HealthParsons, KS, CCN 170120 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Labette HealthParsons, KS, CCN 17U120 Hospital Operational/Managerial Control (5%) Jun 1, 2019
Labette Home HealthParsons, KS, CCN 177254 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 8, 2005
Labette Health St Paul ClinicSaint Paul, KS, CCN 173432 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1995
Labette Health Cherryvale ClinicCherryvale, KS, CCN 178570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 3, 2011
Labette Health Family Practice ClinicParsons, KS, CCN 178571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 3, 2011
Labette Health Independence ClinicIndependence, KS, CCN 178600 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2015
Labette Health Erie ClinicErie, KS, CCN 178608 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 27, 2017
Labette Health Altamont ClinicAltamont, KS, CCN 178607 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 3, 2017
Labette Health Chanute Clinic and Express CareChanute, KS, CCN 178619 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2018
Labette Health Women's and Children's ClinicIndependence, KS, CCN 178618 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 15, 2018
Labette Health Oswego Clinic and Express CareOswego, KS, CCN 178624 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Labette Health Chetopa ClinicChetopa, KS, CCN 178623 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2019

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 167

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.

View all 167

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1205524113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 736",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673570736",
            "telephone_number": "620-820-5889",
            "fax_number": "620-820-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 S TUCKER TER",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626645",
            "telephone_number": "620-291-1101",
            "fax_number": "877-490-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABETTE COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABETTE COUNTY MEDICAL CENTER",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "MACARONAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO / VP",
        "authorized_official_telephone_number": "620-820-5251"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Labette Health Pittsburg Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.