Active NPI
Central Kansas Medical Center
- Specialist
- Great Bend, KS
National Provider Identifier
1295022358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- CENTRAL KANSAS MEDICAL CENTER
- Practice address
- 3515 Broadway Ave
Great Bend, KS 67530-3633 - Phone
- (620) 792-2511
- Fax
- (620) 786-6298
- NPI assigned
- Jul 8, 2011
- Organization subpart
- Yes
- Parent organization
- CENTRAL KANSAS MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Leanne Irsik
- Title
- Senior VP/Site Administrator
- Phone
- (620) 786-6163
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
3515 Broadway Ave
Great Bend, KS 67530-3633
Mailing address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511
Other names 1
- ST ROSE PROFESSIONAL SERVICES
National Provider Directory
National Provider Directory- Part of
- Central KS Medical Cent
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331769600000",
"number": "1295022358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-792-2511",
"fax_number": "620-786-6298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-792-2511",
"fax_number": "620-786-6298"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL KANSAS MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CENTRAL KANSAS MEDICAL CENTER",
"enumeration_date": "2011-07-08",
"last_updated": "2012-03-15",
"status": "A",
"authorized_official_last_name": "IRSIK",
"authorized_official_first_name": "LEANNE",
"authorized_official_title_or_position": "SENIOR VP/SITE ADMINISTRATOR",
"authorized_official_telephone_number": "620-786-6163",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ST ROSE PROFESSIONAL SERVICES",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Great Bend, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.