NPIMap

Organization Active NPI

Heart of Kansas Family Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Stafford, KS
National Provider Identifier
1255856258
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEART OF KANSAS FAMILY HEALTH CARE, INC.
Practice address
412 Grand Ave
Stafford, KS 67578-2010
Phone
(620) 792-5700
Fax
(855) 463-0855
NPI assigned
Aug 10, 2017
Organization subpart
Yes
Parent organization
HEART OF KANSAS FAMILY HEALTH CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Mr. Freddy Gunn
Title
Cfo
Phone
(620) 792-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

412 Grand Ave
Stafford, KS 67578-2010

Mailing address

1905 19TH St
Great Bend, KS 67530-2502
Phone (620) 792-5700

Other names 1

  • Stafford Clinic Site Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171110000221 KS Part A Provider - Federally Qualified Health Center (FQHC) 4486565181 Practice locations: Stafford, KS

Federally qualified health center certification: CCN 171879

Legal name
HEART OF KANSAS FAMILY HEALTH CARE INC
Doing business as
STAFFORD CLINIC SITE
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 2008 in KS
Enrollment address
412 Grand Ave
Stafford, KS 67578-2010

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Heart of Kansas Family Health Care Inc5 organizations share this tax ID, including this one
Part of
Heart of Kansas Family Health Care Inc

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
William B Middleton Individual Contracted Managing EmployeeCeo Sep 23, 2013
Corporate DirectorCeo Sep 23, 2013
Freddy Gunn Individual Operational/Managerial Control Jan 1, 2022
Martha Rivas Individual Corporate DirectorBoard Member Sep 1, 2008

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1255856258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 19TH ST",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675302502",
            "telephone_number": "620-792-5700",
            "fax_number": "855-463-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 GRAND AVE",
            "city": "STAFFORD",
            "state": "KS",
            "postal_code": "675782010",
            "telephone_number": "620-792-5700",
            "fax_number": "855-463-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF KANSAS FAMILY HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEART OF KANSAS FAMILY HEALTH CARE, INC.",
        "enumeration_date": "2017-08-10",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "GUNN",
        "authorized_official_first_name": "FREDDY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-792-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stafford Clinic Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stafford, KS

Sources for this page

Verify at the official NPI Registry.