NPIMap

Organization Active NPI

Kingman Health Clinic, P.a.

  • Family Medicine Physician
  • Kingman, KS
National Provider Identifier
1366450199
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KINGMAN HEALTH CLINIC, P.A.
Practice address
701 E a Ave
Kingman, KS 67068-1723
Phone
(620) 532-5145
Fax
(620) 532-2586
NPI assigned
Aug 4, 2006
Last updated
Sep 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Shane Alexander, D.O.
Title
President
Phone
(620) 532-5145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

701 E a Ave
Kingman, KS 67068-1723

Mailing address

701 E a Ave
Kingman, KS 67068-1723
Phone (620) 532-5145

Other identifiers 2

IdentifierTypeStateIssuer
100397910AMedicaidKS
110669OtherKSBC/BS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1366450199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E A AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681723",
            "telephone_number": "620-532-5145",
            "fax_number": "620-532-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E A AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681723",
            "telephone_number": "620-532-5145",
            "fax_number": "620-532-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN HEALTH CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "620-532-5145",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100397910A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "110669",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.