Southwest Medical Center
Organization Active NPI Psychiatry Physician · Liberal, KS
NPI 1376583997 · NPPES record last updated Dec 12, 2014
Key facts
- NPI
- 1376583997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- SOUTHWEST MEDICAL CENTER
- Practice address
- 315 W 15TH St
Liberal, KS 67901-2455 - Phone
- (620) 629-6578
- Fax
- (620) 629-2472
- NPI assigned
- Jun 8, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHWEST MEDICAL CENTER
Authorized official
- Name
- Mr. William Ermann
- Title
- Ceo
- Phone
- (620) 629-6400
Other NPIs on the same Medicare enrollment 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040805001105 | KS | Part B Supplier - Clinic/Group Practice | 7517941651 |
Receives reassigned benefits from 80 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Meade, KS; Liberal, KS; Johnson, KS; Hugoton, KS |
National Provider Directory
- Part of
- Medical Center Anesth C
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | KS | Yes |
Addresses
Primary practice location
315 W 15TH St
Liberal, KS 67901-2455
Mailing address
315 W 15TH Street
PO Box 1340
Liberal, KS 67905-1340
Phone (620) 629-6758
Other names
- SWMC Psychiatric Clinic
NPI Registry JSON
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1418342400000",
"number": "1376583997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 W 15TH STREET",
"address_2": "PO BOX 1340",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679051340",
"telephone_number": "620-629-6758",
"fax_number": "620-629-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W 15TH ST",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679012455",
"telephone_number": "620-629-6578",
"fax_number": "620-629-2472"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHWEST MEDICAL CENTER",
"enumeration_date": "2006-06-08",
"last_updated": "2014-12-12",
"status": "A",
"authorized_official_last_name": "ERMANN",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "620-629-6400",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SWMC Psychiatric Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Liberal, KS
- Southwest Guidance Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
- Southwest Medical Center
All providers in Liberal, KS · Psychiatry Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.