Jefferson County Memorial Hospital

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

JEFFERSON COUNTY MEMORIAL HOSPITAL

Doing business as

Jefferson Medical Clinic Valley Falls

Practice address

409 Broadway St
Valley Falls, KS 66088-1303

Phone

(913) 774-4340

Fax

(913) 774-3379

NPI assigned

Feb 28, 2011

Last updated

Dec 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lamont Cook

Title

Ceo

Phone

(913) 774-4340

Specialties & licenses 1

Addresses

Other names 1

• Jefferson Medical Clinic Valley Falls Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Jefferson County Memorial Hospital

  dba F. W. Huston Medical Center

  • Psychiatry Physician
  • Nortonville, KS
  • NPI 1215459367

  O20050215000085

  Same enrollment
• Jefferson County Memorial Hospital

  dba FW Huston Medical Clinic

  • Multi-Specialty Clinic/Center
  • Perry, KS
  • NPI 1447660360

  O20050215000085

  Same enrollment
• Jefferson County Memorial Hospital, Inc

  dba Jefferson Medical Clinic

  • Physician Assistant
  • Winchester, KS
  • NPI 1750354908

  O20050215000085

  Same enrollment
• Jefferson County Memorial Hospital, Inc

  • Multi-Specialty Clinic/Center
  • Basehor, KS
  • NPI 1871969865

  O20050215000085

  Same enrollment

Practitioners 1

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.

• Mary L Rardin, MD

  • Family Medicine Physician
  • Atchison, KS
  • NPI 1548237753
  NPD (past)

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1265739288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 DELAWARE ST",
            "city": "WINCHESTER",
            "state": "KS",
            "postal_code": "660974003",
            "telephone_number": "913-774-4340",
            "fax_number": "913-774-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BROADWAY ST",
            "city": "VALLEY FALLS",
            "state": "KS",
            "postal_code": "660881303",
            "telephone_number": "913-774-4340",
            "fax_number": "913-774-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-28",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-774-4340"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Medical Clinic Valley Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dr Bruce L Tillery DDS PA
• Farr Chiropractic Clinic, P.a.
• Stanley J Farr, DC
• Janet Dight, PH.D., LLC
• Jefferson County Fire Dist # 11
• Crystal Dawn Kay, AGNP-C
• Jamie Marie Kester
• Kollhoff Family Pharmacy LLC (Valley Falls Pharmacy)
• Mary Miller, APRN
• Debbie Ann Name, PA-C

• Multi-Specialty Clinic/Center in Valley Falls, KS
• Providers in Valley Falls, KS by specialty
• Multi-Specialty Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.