NPIMap

Organization Active NPI

Hunter Health Clinic Inc

Doing business as Main

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
National Provider Identifier
1376618348
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HUNTER HEALTH CLINIC INC
Doing business as
Main
Practice address
527 N Grove St
Wichita, KS 67214-4520
Phone
(316) 262-2415
Fax
(316) 264-4734
NPI assigned
Nov 22, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Ronald Saal
Title
Cfo
Phone
(316) 262-2415

Specialties & licenses 1

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

Addresses

Primary practice location

527 N Grove St
Wichita, KS 67214-4520

Mailing address

2318 E Central Ave
Wichita, KS 67214-4436
Phone (316) 262-2415

Other identifiers 2

IdentifierTypeStateIssuer
100212200BMedicaidKS
003947OtherKSBCBS GROUP

Other names 1

  • Main Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hunterhealth@khindirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040220001001 KS Part B Supplier - Clinic/Group Practice 5193632941 Receives reassigned benefits from 25 practitioners
5 other NPIs on this enrollment
Practice locations: Wichita, KS
O20081008000187 KS Part A Provider - Federally Qualified Health Center (FQHC) 5193632941 1 other NPI on this enrollment
Practice locations: Wichita, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376618348. Details of each certification follow.

Federally qualified health center certification: CCN 171800

Legal name
HUNTER HEALTH CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 4, 1980 in KS
Enrollment address
527 N Grove St
Wichita, KS 67214-4520

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

527 N Grove St
Wichita, KS 67214
Phone (316) 262-2415

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
David Duncan Individual Corporate Officer Apr 22, 2024
Amber Williams Individual Corporate DirectorBoard Member Aug 28, 2024
Michael Flores Individual Corporate DirectorBoard Member Jan 1, 2025
Vernon Domebo Individual Corporate OfficerSecretary Oct 25, 2018
Niomi Thompson Individual Corporate DirectorBoard Member Aug 28, 2024
Sloane Dyer Individual Corporate DirectorBoard Member Nov 16, 2023
Michael Herbert Individual Corporate OfficerBoard Member Mar 16, 2017
Mike Lowry Individual Corporate DirectorBoard Member Jan 1, 2022
Rachel White Individual Corporate OfficerVice Chair May 17, 2018
Susan Breeden Individual Corporate DirectorBoard Member Jan 1, 2022
Josh Gordan Individual Corporate DirectorTreasurer Aug 28, 2024
Chantal Nez Individual Corporate DirectorBoard Member Jan 1, 2022
Justin White Individual Corporate DirectorBoard Member Mar 23, 2023
Amy E. Feimer Individual Corporate DirectorChief Executive Officer Feb 8, 2016 100%
W-2 Managing EmployeeChief Executive Officer Feb 8, 2016 100%

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1376618348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 E CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144436",
            "telephone_number": "316-262-2415",
            "fax_number": "316-262-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 N GROVE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144520",
            "telephone_number": "316-262-2415",
            "fax_number": "316-264-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTER HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "SAAL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "316-262-2415"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100212200B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "003947",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hunterhealth@khindirect.org",
            "affiliation": "N",
            "endpointDescription": "Facility",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "527 N Grove St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672144520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Main",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.