NPIMap

Organization Active NPI

Ellsworth County Medical Center

  • Interventional Pain Medicine Physician
  • Ellsworth, KS
National Provider Identifier
1457998593
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
ELLSWORTH COUNTY MEDICAL CENTER
Practice address
1604 Aylward Ave
Ellsworth, KS 67439-2541
Phone
(785) 472-3111
Fax
(785) 472-5760
NPI assigned
Dec 9, 2019
Last updated
Mar 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
James Kirkbride
Title
Ceo
Phone
(785) 472-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

1604 Aylward Ave
Ellsworth, KS 67439-2541

Mailing address

PO Box 87
Ellsworth, KS 67439-0087
Phone (785) 472-3111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716000216 KS Part B Supplier - Clinic/Group Practice 5395643357 Receives reassigned benefits from 35 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellsworth, KS

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

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1457998593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674390087",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 AYLWARD AVE",
            "city": "ELLSWORTH",
            "state": "KS",
            "postal_code": "674392541",
            "telephone_number": "785-472-3111",
            "fax_number": "785-472-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "KIRKBRIDE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-472-3111"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.