Jaclyn M Vath, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

75788 Issued in KS

Practice address

106 N Main St
Cimarron, KS 67835-8880

Phone

(620) 855-4456

Fax

(620) 855-4459

NPI assigned

Oct 24, 2012

Last updated

Mar 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonspirit Kansas IncGroup PAC ID 4789595844, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of the Prairie Home health agency, Dodge City, KS, CCN 178005
• St. Catherine Hospital - Garden City Hospital, Garden City, KS, CCN 170023
• Centura St. Catherine-Dodge City Hospital, Dodge City, KS, CCN 170175

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Commonspirit Kansas, Inc.

  dba St. Catherine Hospital - Garden City

  • General Acute Care Hospital
  • Garden City, KS
  • NPI 1659360196
  Medicare reassignment Care Compare group NPD
• Commonspirit Kansas, Inc.

  • Pediatrics Physician
  • Garden City, KS
  • NPI 1922558279
  NPD
• St Catherine Hospital

  • Family Medicine Physician
  • Ulysses, KS
  • NPI 1528771029
  NPD
• Commonspirit Kansas, Inc.

  • Family Medicine Physician
  • Cimarron, KS
  • NPI 1255044897
  NPD (past)
• St. Catherine Hospital

  dba St Catherine Physician Services

  • Internal Medicine Physician
  • Garden City, KS
  • NPI 1053533844
  NPD (past)

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

• Commonspirit Kansas, Inc.

  dba St. Catherine Hospital - Garden City

  • General Acute Care Hospital
  • Garden City, KS
  • NPI 1659360196
  Care Compare affiliation
• Commonspirit Kansas, Inc.

  dba St. Catherine Hospital - Dodge City

  • General Acute Care Hospital
  • Dodge City, KS
  • NPI 1689317190
  Care Compare affiliation
• Hospice of the Prairie, Inc.

  • Home Health Agency
  • Dodge City, KS
  • NPI 1508829821
  Care Compare affiliation

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1316290612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N MAIN ST",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "67835",
            "telephone_number": "620-855-4456",
            "fax_number": "620-855-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N MAIN ST",
            "city": "CIMARRON",
            "state": "KS",
            "postal_code": "678358880",
            "telephone_number": "620-855-4456",
            "fax_number": "620-855-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATH",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "75788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004327880002",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pinnacle Pharmacy Group Inc (Comprehensive Health Services (CHS Pharmacy))
• Racy's Medical Clinic
• Randall K Cundiff (Racy's Medical Clinic)
• Shepherd of the Plains Foundation (The Shepherd's Center)
• Usd 102 Cimarron-Ensign
• Western Legacy Physical Therapy, LLC
• Western Plains Physician Practices, LLC (Western Plains Primary Care)

• Family Nurse Practitioner in Cimarron, KS
• Providers in Cimarron, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.