Fort Scott Family Medicine, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FORT SCOTT FAMILY MEDICINE, P.A.

Practice address

202 State St
Suite a
Fort Scott, KS 66701-2031

Phone

(620) 223-3950

Fax

(620) 223-1302

NPI assigned

Aug 19, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ricky D Kellenberger, D.O.NPI 1700864568

Title

President

Phone

(620) 223-3950

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 4

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.

• Ricky Kellenberger, D.O

  • Family Medicine Physician
  • Fort Scott, KS
  • NPI 1700864568
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Lewis

  • Family Nurse Practitioner
  • Fort Scott, KS
  • NPI 1265839690
  Medicare reassignment Care Compare group NPD
• Randy Kellenberger, D.O.

  • Emergency Medicine Physician
  • Atchison, KS
  • NPI 1932186681
  Medicare reassignment NPD
• Heather Dawn Burns, DNP, APRN

  • Family Nurse Practitioner
  • Pittsburg, KS
  • NPI 1093337701
  NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467566802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "address_2": "SUITE A",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667012031",
            "telephone_number": "620-223-3950",
            "fax_number": "620-223-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "address_2": "SUITE A",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667012031",
            "telephone_number": "620-223-3950",
            "fax_number": "620-223-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT SCOTT FAMILY MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLENBERGER",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "620-223-3950",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly K Ferguson, LMLP
• Mary Jo Flint, M.D.
• Tanner Dean Forrest, ATC
• Fort Scott Chiropractic LLC
• Fort Scott Family Medicine
• Fort Scott Usd 234
• Destiny Denise Foulk, OD
• Foxx Apothecary, Inc
• W. J. Bryan Foxx, II, RPH
• Franklin House

• Family Medicine Physician in Fort Scott, KS
• Providers in Fort Scott, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.