NPIMap

Individual provider Active NPI

Gina M Westhoff, PA

  • Family Medicine Physician
  • Great Bend, KS
National Provider Identifier
1215967849
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15-00947 Issued in KS
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 792-2511
Fax
(620) 792-3767
NPI assigned
Jul 3, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0425245 KS
Family Medicine Physician 207Q00000X 15-00947 KS Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511

Other identifiers 3

IdentifierTypeStateIssuer
659930OtherFIRST GUARD
042053OtherBCBS
200300590AMedicaidKS

Other names 1

  • Gina M. Bailey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000818 KS Practitioner - Physician Assistant 8224926431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukhs Great Bend LLCGroup PAC ID 5597016378, 64 clinicians

Practice addresses (Care Compare)

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0425245KSMDMedical Physician Assistant
15-00947KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ukhs Great Bend, LLC Family Medicine CurrentSince May 8, 2019 Accepting new patients
Mid-America Cardiology Associates, Inc. Past Accepting new patients

Locations

1309 Polk St
Great Bend, KS 67530
Phone (620) 792-5341

3515 Broadway Ave
Great Bend, KS 67530
Phone (620) 786-6163

514 Cleveland St
Great Bend, KS 67530
Phone (620) 659-2890

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1215967849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-2511",
            "fax_number": "620-792-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-2511",
            "fax_number": "620-792-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTHOFF",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "0425245",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "15-00947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD",
            "identifier": "659930",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "042053",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300590A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "BAILEY",
            "middle_name": "M.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.