NPIMap

Organization Active NPI

Medicine Lodge Memorial Hospital

  • Critical Access Hospital Clinic/Center
  • Medicine Lodge, KS
National Provider Identifier
1285669929
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
License
H004002 Issued in KS
Legal business name
MEDICINE LODGE MEMORIAL HOSPITAL
Practice address
701 N Walnut St
Drawer 'C'
Medicine Lodge, KS 67104-1018
Phone
(620) 886-3771
Fax
(620) 886-5012
NPI assigned
Jul 11, 2006
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Ms. Ashley Taylor
Title
Administrator
Phone
(620) 886-3771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X H004002 KS Primary

Addresses

Primary practice location

701 N Walnut St
Drawer 'C'
Medicine Lodge, KS 67104-1018

Mailing address

701 N Walnut St
Drawer 'C'
Medicine Lodge, KS 67104-1018
Phone (620) 886-3771

Other identifiers 1

IdentifierTypeStateIssuer
100092110BMedicaidKS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address MedicineLodge.Hospital@MedicineLodge-GPHA.cernerdirect.com Direct
Direct Messaging Address MedicineLodge.Clinic@MedicineLodge-GPHA.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040813000561 KS Part B Supplier - Clinic/Group Practice 6901879410 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medicine Lodge, KS

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1285669929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N WALNUT ST",
            "address_2": "DRAWER 'C'",
            "city": "MEDICINE LODGE",
            "state": "KS",
            "postal_code": "671041018",
            "telephone_number": "620-886-3771",
            "fax_number": "620-886-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N WALNUT ST",
            "address_2": "DRAWER 'C'",
            "city": "MEDICINE LODGE",
            "state": "KS",
            "postal_code": "671041018",
            "telephone_number": "620-886-3771",
            "fax_number": "620-886-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE LODGE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-886-3771",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "KS",
            "license": "H004002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092110B",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MedicineLodge.Hospital@MedicineLodge-GPHA.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Medicine Lodge Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "710 N Walnut St",
            "city": "Medicine Lodge",
            "state": "KS",
            "country_code": "US",
            "postal_code": "671041019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MedicineLodge.Clinic@MedicineLodge-GPHA.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Medicine Lodge Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "710 N Walnut St",
            "city": "Medicine Lodge",
            "state": "KS",
            "country_code": "US",
            "postal_code": "671041019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medicine Lodge, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.