NPIMap

Organization Active NPI

Jefferson County Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Basehor, KS
National Provider Identifier
1457710790
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
H044001 Issued in KS
Legal business name
JEFFERSON COUNTY MEMORIAL HOSPITAL
Practice address
15630 Pinehurst Dr
Suite 5
Basehor, KS 66007-8233
Phone
(913) 662-7042
Fax
(913) 662-7046
NPI assigned
Feb 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Authorized official

Name
Lamont Cook
Title
Ceo
Phone
(913) 774-4340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X H044001 KS Primary

Addresses

Primary practice location

15630 Pinehurst Dr
Suite 5
Basehor, KS 66007-8233

Mailing address

408 Delaware St
Winchester, KS 66097-4003
Phone (913) 774-4340

Other identifiers 2

IdentifierTypeStateIssuer
100080370FMedicaidKS
110046OtherKSMEDICARE

Other names 1

  • FW Huston Urgent Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Co Mem Hosp Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

15630 Pinehurst Dr
Ste 5
Basehor, KS 66007
Phone (913) 662-7042

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1457710790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 DELAWARE ST",
            "city": "WINCHESTER",
            "state": "KS",
            "postal_code": "660974003",
            "telephone_number": "913-774-4340",
            "fax_number": "913-774-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15630 PINEHURST DR",
            "address_2": "SUITE 5",
            "city": "BASEHOR",
            "state": "KS",
            "postal_code": "660078233",
            "telephone_number": "913-662-7042",
            "fax_number": "913-662-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-774-4340"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KS",
            "license": "H044001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100080370F",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "110046",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FW Huston Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Basehor, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.