NPIMap

Organization Active NPI

Mercy Kansas Communities Inc

Doing business as Cherryvale Family Medicine

  • Rural Health Clinic/Center
  • Cherryvale, KS
National Provider Identifier
1467564039
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
1500335 Issued in KS
Legal business name
MERCY KANSAS COMMUNITIES INC
Doing business as
Cherryvale Family Medicine
Practice address
203 W Main St
Cherryvale, KS 67335-1332
Phone
(620) 336-2132
Fax
(620) 336-2237
NPI assigned
Aug 31, 2006
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Mrs. Shelly Hunter
Title
Cfo
Phone
(417) 625-2459

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 1500335 KS Primary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 1500335 KS

Addresses

Primary practice location

203 W Main St
Cherryvale, KS 67335-1332

Mailing address

PO Box 414
203 West Main Street
Cherryvale, KS 67335-0414
Phone (620) 336-2132

Other identifiers 1

IdentifierTypeStateIssuer
100089300IMedicaidKS

Other names 1

  • Cherryvale Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital of Kansas Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2016 Change of OwnershipThis provider was the seller Cherryvale Family MedicineCCN 178593, KS, NPI 1598121790

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1467564039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "address_2": "203 WEST MAIN STREET",
            "city": "CHERRYVALE",
            "state": "KS",
            "postal_code": "673350414",
            "telephone_number": "620-336-2132",
            "fax_number": "620-336-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W MAIN ST",
            "city": "CHERRYVALE",
            "state": "KS",
            "postal_code": "673351332",
            "telephone_number": "620-336-2132",
            "fax_number": "620-336-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY KANSAS COMMUNITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-625-2459",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KS",
            "license": "1500335",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1500335",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089300I",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherryvale Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherryvale, KS

Sources for this page

Verify at the official NPI Registry.