NPIMap

Organization Active NPI

Central Care, PA

Doing business as Central Care Cancer Center

  • Specialist
  • Liberal, KS
National Provider Identifier
1245576909
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CENTRAL CARE, PA
Doing business as
Central Care Cancer Center
Practice address
305 W 15TH St
Suite 203
Liberal, KS 67901-2455
Phone
(620) 624-4700
Fax
(888) 235-3625
NPI assigned
Dec 27, 2012
Last updated
Apr 20, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL CARE, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Stacy Cloyd
Title
Credentialing Manager
Phone
(785) 823-0633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

305 W 15TH St
Suite 203
Liberal, KS 67901-2455

Mailing address

PO Box 256
Salina, KS 67402-0256
Phone (785) 823-0633

Other identifiers 3

IdentifierTypeStateIssuer
100143020CMedicaidKS
10026517302MedicaidNE
200480600BMedicaidOK

Other names 1

  • Central Care Cancer Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000823 KS Part B Supplier - Clinic/Group Practice 7911801014 Receives reassigned benefits from 11 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Scott City, KS; Salina, KS; Newton, KS; Garden City, KS; Emporia, KS; El Dorado, KS; Great Bend, KS

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
Invalid Entry

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1245576909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 256",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674020256",
            "telephone_number": "785-823-0633",
            "fax_number": "844-854-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W 15TH ST",
            "address_2": "SUITE 203",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012455",
            "telephone_number": "620-624-4700",
            "fax_number": "888-235-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CARE, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL CARE, PA",
        "enumeration_date": "2012-12-27",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "CLOYD",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "785-823-0633"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100143020C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026517302",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200480600B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Care Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberal, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.