Organization Active NPI

Pitt Family Clinic, LLC

  • Primary Care Clinic/Center
  • Pittsburg, KS
National Provider Identifier
1285362830
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PITT FAMILY CLINIC, LLC
Practice address
2401 S Tucker Ave Ste 4
Pittsburg, KS 66762-6619
Phone
(620) 301-0264
NPI assigned
Aug 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Kyra Dawn Jent, APRNNPI 1467183194
Title
FNP
Phone
(620) 301-0264

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2401 S Tucker Ave Ste 4
Pittsburg, KS 66762-6619

Mailing address

2401 S Tucker Ave Ste 4
Pittsburg, KS 66762-6619
Phone (620) 301-0264

National Provider Directory

National Provider Directory
Tax ID family
Pitt Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

613 N Broadway St
Ste F
Pittsburg, KS 66762

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1285362830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER AVE STE 4",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626619",
            "telephone_number": "620-301-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER AVE STE 4",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667626619",
            "telephone_number": "620-301-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITT FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "JENT",
        "authorized_official_first_name": "KYRA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "620-301-0264",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.