Community Health Center of Southeast Kansas, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC

Practice address

312 S Maple St
Garnett, KS 66032-1333

Phone

(888) 777-9170

NPI assigned

Sep 9, 2022

Organization subpart

No

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

Authorized official

Name

Daniel Spencer Creitz

Title

Compliance Officer

Phone

(620) 240-5015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 171916

Legal name

COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 10, 2022

Last certification

Nov 10, 2022

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 1, 2022 in KS

Enrollment address

312 S Maple St
Garnett, KS 66032-1333

Other NPIs on the same Medicare enrollment 23

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

• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, KS
  • NPI 1417656166

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Baxter Springs, KS
  • NPI 1487351086

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Coffeyville, KS
  • NPI 1649557281

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1669474425

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Pittsburg, KS
  • NPI 1174525943

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Humboldt, KS
  • NPI 1225577786

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Coffeyville, KS
  • NPI 1487939773

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Parsons, KS
  • NPI 1669858973

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc

  • Federally Qualified Health Center (FQHC)
  • Independence, KS
  • NPI 1801208053

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Coffeyville, KS
  • NPI 1063844629

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pleasanton, KS
  • NPI 1063997377

  O20040209000163

  Same enrollment
• Community Health Center of Southeast Kansas, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arma, KS
  • NPI 1083199392

  O20040209000163

  Same enrollment

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 16

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

All facility ownership & control disclosures 19

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ross M Kimball, MD

  • Family Medicine Physician
  • Garnett, KS
  • NPI 1982876512
  NPD
• Virginia King

  • Medical Physician Assistant
  • Coffeyville, KS
  • NPI 1578663183
  NPD
• Frank David Miller, D.C.

  • Chiropractor
  • Fort Scott, KS
  • NPI 1609985795
  NPD
• David Michael Torchia, PA-C

  • Physician Assistant
  • Pittsburg, KS
  • NPI 1538134937
  NPD

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1225759996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S MAPLE ST",
            "city": "GARNETT",
            "state": "KS",
            "postal_code": "660321333",
            "telephone_number": "888-777-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "CREITZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "620-240-5015"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Renae Bell
• Karen Briggs, P.T.
• Stacy Renee Brown, COTA/L
• Michael William Burns, RPH
• Cranston Jay Cederlind, M.D.
• Jordan Davied, PHARM.D
• Bryce Douglas Dieker
• Kendra Rovello Erickson, RDN, LD
• Tanya Renee Ewert, APRN
• Dillan Findley, RPH

• All providers in Garnett, KS
• Federally Qualified Health Center (FQHC) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.