NPIMap

Organization Active NPI

Southwest Medical Center

Doing business as SWMC Psychiatric Clinic

  • Psychiatry Physician
  • Liberal, KS
National Provider Identifier
1376583997
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTHWEST MEDICAL CENTER
Doing business as
SWMC Psychiatric Clinic
Practice address
315 W 15TH St
Liberal, KS 67901-2455
Phone
(620) 629-6578
Fax
(620) 629-2472
NPI assigned
Jun 8, 2006
Last updated
Dec 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Authorized official

Name
Mr. William Ermann
Title
Ceo
Phone
(620) 629-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X KS Primary

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 1

  • SWMC Psychiatric Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
SWMC Specialty Clinic

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.