NPIMap

Organization Active NPI

Konza Prairie Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Junction City, KS
National Provider Identifier
1447247663
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KONZA PRAIRIE COMMUNITY HEALTH CENTER, INC.
Practice address
361 Grant Ave
Junction City, KS 66441-4201
Phone
(785) 238-4711
Fax
(785) 530-6150
NPI assigned
Oct 3, 2005
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Danielle Hallgren
Title
Ceo
Phone
(785) 238-4711

Specialties & licenses 1

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

Addresses

Primary practice location

361 Grant Ave
Junction City, KS 66441-4201

Mailing address

361 Grant Ave
Junction City, KS 66441-4201
Phone (785) 238-4711

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040109000751 KS Part B Supplier - Clinic/Group Practice 3779483466 Receives reassigned benefits from 21 practitioners
2 other NPIs on this enrollment
Practice locations: Junction City, KS; Manhattan, KS; Chapman, KS
O20040505001063 KS Part A Provider - Federally Qualified Health Center (FQHC) 3779483466 Practice locations: Junction City, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447247663. Details of each certification follow.

Federally qualified health center certification: CCN 171804

Legal name
KONZA PRAIRIE COMMUNITY HEALTH CENTER INC
Doing business as
KONZA PRAIRIE COMMUNITY HEALTH AND DENTAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 27, 1995
Last certification
Jun 27, 1995
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 31, 1994 in KS
Enrollment address
361 Grant Ave
Junction City, KS 66441-4201

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 2

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Paula Pedersen Individual W-2 Managing EmployeeRCM Jan 3, 2022
Lisa Osbourn Individual Corporate DirectorBoard Member; Secretary/Tresurer Dec 20, 2010
Margaret Kilpatrick Individual Corporate DirectorBoard Member Feb 1, 2022
Vicky D. Minton Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing EmployeeCfo Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Gene Parrish Individual Corporate DirectorBoard Member Aug 2, 2010
Danielle Hallgren Individual Corporate OfficerCeo Dec 16, 2022
W-2 Managing EmployeeCeo Dec 16, 2022
Operational/Managerial ControlCeo Dec 16, 2022
Susan Adamchak Individual Corporate DirectorBoard Member Jul 1, 2023
Aaron Estabrook Individual Corporate DirectorBoard Member Mar 27, 2020
Irene Portillo Individual Contracted Managing EmployeeCredentialing Manager Jun 17, 2024
Tom Brungardt Individual Corporate DirectorBoard Chairman Mar 22, 2013
Carol Lawson Individual Corporate DirectorBoard Member Jul 1, 2023
Florence C. Whitebread Individual Corporate DirectorBoard Member Aug 2, 2010
Dustie Angela Samuels Individual W-2 Managing EmployeeMD; Mar 4, 2024
Myron Coryell Individual Corporate DirectorBoard Member Aug 2, 2010
Leann Kooken Individual Corporate OfficerCoo Feb 6, 2023
W-2 Managing EmployeeCoo Feb 6, 2023
Operational/Managerial ControlCoo Feb 6, 2023
Lawrence P. Palmer Individual Corporate DirectorVice Chairman Jan 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 4

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

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1447247663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 GRANT AVE",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414201",
            "telephone_number": "785-238-4711",
            "fax_number": "785-530-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 GRANT AVE",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414201",
            "telephone_number": "785-238-4711",
            "fax_number": "785-530-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONZA PRAIRIE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "HALLGREN",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-238-4711"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

Verify at the official NPI Registry.