NPIMap

Organization Active NPI

Commonspirit Kansas, Inc.

  • Family Medicine Physician
  • Cimarron, KS
National Provider Identifier
1255044897
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMONSPIRIT KANSAS, INC.
Practice address
106 N Main St
Cimarron, KS 67835-8880
Phone
(620) 855-4456
Fax
(620) 855-4459
NPI assigned
Dec 28, 2022
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Angela Jo Skinner
Title
Administrator
Phone
(720) 667-7283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

106 N Main St
Cimarron, KS 67835-8880

Mailing address

PO Box 803929
Kansas City, MO 64180-3929
Phone (888) 347-3295

Other identifiers 1

IdentifierTypeStateIssuer
30003913010041MedicaidKS

Other names 4

  • St Catherine Hospital Former legal business name
  • CommonSpirit Primary Care Cimarron Other name
  • Primary Care Cimarron Other name
  • SCDC PC CIMARRON Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050302000707 KS Part B Supplier - Clinic/Group Practice 4789595844 Receives reassigned benefits from 87 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cimarron, KS; Ulysses, KS; Liberal, KS; Garden City, KS; Dodge City, KS

Other NPIs on the same Medicare enrollment 26

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

View all 26

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
17D2051820Commonspirit Primary Care Cimarron106 North Main Street, Cimarron, KS 67835Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
St Catherine Hosp Lab27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 3

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": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1255044897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803929",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641803929",
            "telephone_number": "888-347-3295",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N MAIN ST",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "678358880",
            "telephone_number": "620-855-4456",
            "fax_number": "620-855-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONSPIRIT KANSAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "720-667-7283"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003913010041",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Catherine Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CommonSpirit Primary Care Cimarron",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Primary Care Cimarron",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SCDC PC CIMARRON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cimarron, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.