NPIMap

Organization Active NPI

Spring River Mental Health & Wellness, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverton, KS
National Provider Identifier
1447393533
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SPRING RIVER MENTAL HEALTH & WELLNESS, INC.
Practice address
6610 SE Quakervale Rd
Riverton, KS 66770-4185
Phone
(620) 848-2300
Fax
(620) 848-2304
NPI assigned
Feb 15, 2007
Last updated
Oct 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Authorized official

Name
Mr. Robert Scott Jackson
Title
Executive Director
Phone
(620) 848-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6610 SE Quakervale Rd
Riverton, KS 66770-4185

Mailing address

PO Box 550
Riverton, KS 66770-0550
Phone (620) 848-2300

Other practice location 1

201 W Walnut St
Columbus, KS 66725-1121
Phone (620) 429-1860

Other identifiers 1

IdentifierTypeStateIssuer
100098150AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000656 KS Part B Supplier - Clinic/Group Practice 0446152433 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Columbus, KS; Riverton, KS

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Spring River Mental Health and Wellness Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1447393533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "RIVERTON",
            "state": "KS",
            "postal_code": "667700550",
            "telephone_number": "620-848-2300",
            "fax_number": "620-848-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6610 SE QUAKERVALE RD",
            "city": "RIVERTON",
            "state": "KS",
            "postal_code": "667704185",
            "telephone_number": "620-848-2300",
            "fax_number": "620-848-2304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "KS",
            "postal_code": "667251121",
            "country_code": "US",
            "telephone_number": "620-429-1860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRING RIVER MENTAL HEALTH & WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "620-848-2300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098150A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.