NPIMap

Individual provider Active NPI

Justin M. Poore, D.O.

  • Family Medicine Physician
  • Concordia, KS
National Provider Identifier
1306849161
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0529357 Issued in KS
Practice address
1100 Highland Dr
FL 3
Concordia, KS 66901-3923
Phone
(785) 243-4272
Fax
(785) 243-4275
NPI assigned
May 24, 2005
Last updated
Dec 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0529357 KS Primary

Addresses

Primary practice location

1100 Highland Dr
FL 3
Concordia, KS 66901-3923

Mailing address

1518 Quail Rd
Concordia, KS 66901-6885

Other identifiers 1

IdentifierTypeStateIssuer
100415450BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910001017 KS Practitioner - Family Practice 8729182548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cloud County Health Center IncGroup PAC ID 4082522859, shared by 4 NPIs, 15 clinicians
Clay County Medical CenterGroup PAC ID 6901959436, shared by 8 NPIs, 44 clinicians

Practice addresses (Care Compare)

155 W College Dr
Concordia, KS 66901-5207
Phone (785) 243-1234

311 Washington St
Clyde, KS 66938-9664
Phone (785) 243-4272

609 Liberty St
Clay Center, KS 67432-1564
Phone (785) 632-2181

617 Liberty St
Clay Center, KS 67432-1564
Phone (785) 632-2144

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.54 of 100Reported as group
Quality
74.55
Promoting interoperability
100
Improvement activities
40
Cost
53.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0529357KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud County Health Center Inc CurrentSince Aug 1, 2003 Accepting new patients
Cloud County Health Center Inc CurrentSince Aug 1, 2003 Accepting new patients
Cloud County Health Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Sunset Home, Inc. Past Accepting new patients

Locations

155 W College Dr
Concordia, KS 66901
Phone (785) 243-1234

311 Walnut St
Jamestown, KS 66948
Phone (785) 243-4272

501 S Santa Fe Ave
Ste 200
Salina, KS 67401
Phone (785) 452-7245

Interoperability endpoints

  • Direct secure messaging: justin.poore@khindirect.org
  • Direct secure messaging: justin.poore@srhcdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1306849161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 QUAIL RD",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669016885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HIGHLAND DR",
            "address_2": "FL 3",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669013923",
            "telephone_number": "785-243-4272",
            "fax_number": "785-243-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORE",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0529357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100415450B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concordia, KS

Sources for this page

Verify at the official NPI Registry.