Active NPI
Southwest Medical Center
- Psychiatric Hospital Unit
- Liberal, KS
National Provider Identifier
1447294145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- Legal business name
- SOUTHWEST MEDICAL CENTER
- Practice address
- 315 W 15TH Street
Liberal, KS 67901-2455 - Phone
- (620) 624-1651
- Fax
- (620) 629-2474
- NPI assigned
- Jun 15, 2006
- Organization subpart
- Yes
- Parent organization
- SOUTHWEST MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Delany Fawkes
- Title
- Cfo/VP of Finance
- Phone
- (620) 629-6300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | KS | Primary |
Addresses
Primary practice location
315 W 15TH Street
Liberal, KS 67901-2455
Mailing address
315 W 15TH Street
PO Box 1340
Liberal, KS 67905-1340
Phone (620) 624-1651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000812 | Other | KS | BLUE CROSS BLUE SHIELD |
Other names 1
- Southwest Medical Center Psychiatric Facility
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Medical Center Anesth C
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1252972800000",
"number": "1447294145",
"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": "620-624-1651",
"fax_number": "620-629-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W 15TH STREET",
"city": "LIBERAL",
"state": "KS",
"postal_code": "679012455",
"telephone_number": "620-624-1651",
"fax_number": "620-629-2474"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHWEST MEDICAL CENTER",
"enumeration_date": "2006-06-15",
"last_updated": "2009-09-15",
"status": "A",
"authorized_official_last_name": "FAWKES",
"authorized_official_first_name": "DELANY",
"authorized_official_title_or_position": "CFO/VP OF FINANCE",
"authorized_official_telephone_number": "620-629-6300",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "KS",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000812",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Southwest Medical Center Psychiatric Facility",
"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 Sep 15, 2009; 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.