NPIMap

Organization Active NPI

Fort Scott Family Medicine

  • Family Nurse Practitioner
  • Fort Scott, KS
National Provider Identifier
1255601944
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-75555-122 Issued in KS
Legal business name
FORT SCOTT FAMILY MEDICINE
Practice address
202 State St
Suite a
Fort Scott, KS 66701-2031
Phone
(620) 223-3950
NPI assigned
Jan 11, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Ricky Kellenberger, D.ONPI 1700864568
Title
Physician
Phone
(620) 224-3511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 9

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

National Provider Directory

National Provider Directory

Locations

202 State St
Ste A
Fort Scott, KS 66701
Phone (620) 223-3950

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 53-75555-122 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

202 State St
Suite a
Fort Scott, KS 66701-2031

Mailing address

202 State St
Suite a
Fort Scott, KS 66701-2031
Phone (620) 223-3950

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 1, 2012.

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1255601944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "address_2": "SUITE A",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667012031",
            "telephone_number": "620-223-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "address_2": "SUITE A",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667012031",
            "telephone_number": "620-223-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT SCOTT FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "KELLENBERGER",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "620-224-3511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-75555-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Scott, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.