NPIMap

Organization Active NPI

Community Health Center in Cowley County Inc

  • Federally Qualified Health Center (FQHC)
  • Arkansas City, KS
National Provider Identifier
1336969500
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC
Practice address
600 S B St
Arkansas City, KS 67005-3469
Phone
(620) 221-3350
Fax
(620) 221-6061
NPI assigned
Oct 14, 2024
Last updated
Oct 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
David Edward Brazil
Title
Ceo
Phone
(620) 221-3350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

600 S B St
Arkansas City, KS 67005-3469

Mailing address

118 W 9TH Ave
Winfield, KS 67156-2852
Phone (620) 221-3350

Other names 1

  • Lincoln Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250106003103 KS Part A Provider - Federally Qualified Health Center (FQHC) 9537473095 Practice locations: Arkansas City, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336969500. Details of each certification follow.

Federally qualified health center certification: CCN 171031

Legal name
COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 2025
Last certification
Jan 1, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
600 S B St
Arkansas City, KS 67005-3469

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

600 S B St
Arkansas City, KS 67005
Phone (620) 221-3350

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lorri Greenlee Individual Corporate Director Jan 1, 2023
Brady Dutton Individual Corporate Officer Dec 17, 2018
W-2 Managing Employee Dec 17, 2018
Julie Ross Individual Corporate Director Jan 1, 2020
Charles Quinn Individual Corporate Director Jul 1, 2022
Treasure a Wehner Individual Corporate Officer Jul 28, 2015
Kenneth Trimmer Individual Corporate Director Jan 1, 2020
David E Brazil Individual Corporate Officer Jul 28, 2015
Corporate Director Jul 28, 2015
W-2 Managing Employee Jul 28, 2015
Peggy Soule Individual Corporate Director Jan 1, 2025
Melody E Vaden Individual Corporate Officer Jul 28, 2015
W-2 Managing Employee Jul 28, 2015
Carina Givens Individual Corporate Director Jan 1, 2020
Lindsay Wilke Individual Corporate Director Jan 1, 2022
Gayle McPherson Individual Corporate Director Jan 1, 2025
Jacque Arnett Individual Corporate Director Jan 1, 2025

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1336969500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W 9TH AVE",
            "city": "WINFIELD",
            "state": "KS",
            "postal_code": "671562852",
            "telephone_number": "620-221-3350",
            "fax_number": "620-221-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S B ST",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670053469",
            "telephone_number": "620-221-3350",
            "fax_number": "620-221-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER IN COWLEY COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "BRAZIL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-221-3350"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arkansas City, KS

Sources for this page

Verify at the official NPI Registry.