NPIMap

Organization Active NPI

Pratt Regional Medical Center Corporation

  • General Practice Physician
  • Pratt, KS
National Provider Identifier
1417039355
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PRATT REGIONAL MEDICAL CENTER CORPORATION
Practice address
200 Commodore St
Pratt, KS 67124-2903
Phone
(620) 672-7451
NPI assigned
Oct 19, 2006
Organization subpart
Yes
Parent organization
PRATT REGIONAL MEDICAL CENTER CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Tammy Smith
Title
Ceo
Phone
(620) 672-7451

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

200 Commodore St
Pratt, KS 67124-2903

Mailing address

200 Commodore St
Pratt, KS 67124-2903
Phone (620) 672-7451

Other names 2

  • Emergency Room Physicial Group Doing business as
  • PRMC Hospital Physician Billing Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419001344 KS Part B Supplier - Clinic/Group Practice 1355253238 Receives reassigned benefits from 45 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pratt, KS; Dodge City, KS

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
Tax ID family
Maxine a Lingurar MD5 organizations share this tax ID, including this one
Part of
Maxine a Lingurar MD

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1417039355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COMMODORE ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242903",
            "telephone_number": "620-672-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT REGIONAL MEDICAL CENTER CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRATT REGIONAL MEDICAL CENTER CORPORATION",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-672-7451"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Room Physicial Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRMC Hospital Physician Billing Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pratt, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.