Organization Active NPI

Partners in Family Care LLC

  • Family Medicine Physician
  • Moundridge, KS
National Provider Identifier
1417923780
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PARTNERS IN FAMILY CARE LLC
Practice address
200 E Pack
Moundridge, KS 67107-0640
Phone
(620) 345-6322
Fax
(620) 345-3038
NPI assigned
Feb 27, 2006
Last updated
May 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Paul D Ullom-Minnich, M.D.NPI 1326043241
Title
M.D.
Phone
(620) 345-6322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

200 E Pack
Moundridge, KS 67107-0640

Mailing address

200 East Pack
Moundridge, KS 67107-0640
Phone (620) 345-6322

Other identifiers 4

IdentifierTypeStateIssuer
110273OtherKSBS GROUP ID NUMBER
100273280AMedicaidKS
460682MedicaidKS
460679MedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524001335 KS Part B Supplier - Clinic/Group Practice 2961493242 Receives reassigned benefits from 9 practitioners
Practice locations: Hesston, KS; Inman, KS; McPherson, KS; Moundridge, KS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0451120Partners in Family Care200 E Pack Street, Moundridge, KS 67107Certificate of waiverMay 5, 2028

National Provider Directory

National Provider Directory

Locations

110 E Smith St
Hesston, KS 67062
Phone (620) 327-2314

371 N Old 81 Hwy
Hesston, KS 67062
Phone (620) 327-2314

1600 E Euclid St
McPherson, KS 67460
Phone (620) 242-0584

Practitioners & affiliated clinicians

Practitioners 9

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": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1417923780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAST PACK",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671070640",
            "telephone_number": "620-345-6322",
            "fax_number": "620-345-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PACK",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671070640",
            "telephone_number": "620-345-6322",
            "fax_number": "620-345-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "ULLOM-MINNICH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "620-345-6322",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS GROUP ID NUMBER",
            "identifier": "110273",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100273280A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460682",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460679",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moundridge, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.