NPIMap

Organization Active NPI

Ottawa Family Physicians, Chartered

  • Family Medicine Physician
  • Ottawa, KS
National Provider Identifier
1477598837
Registry record updated Oct 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OTTAWA FAMILY PHYSICIANS, CHARTERED
Practice address
1418 S Main St
Suite 5
Ottawa, KS 66067-3543
Phone
(785) 242-1620
Fax
(785) 242-3825
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2009

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

Authorized official

Name
Dr. Dennis Phillip Spratt, M.D.NPI 1679509236
Title
President
Phone
(785) 242-1620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

1418 S Main St
Suite 5
Ottawa, KS 66067-3543

Mailing address

1418 S Main St
Suite 5
Ottawa, KS 66067-3543
Phone (785) 242-1620

Other identifiers 3

IdentifierTypeStateIssuer
003800OtherKSBLUE CROSS BLUE SHIELD GR
100004330BMedicaidKS
100004330EMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050222000840 KS Part B Supplier - Clinic/Group Practice 7416900113 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Ottawa, KS
O20101104001009 KS Part A Provider - Rural Health Clinic 7416900113 Practice locations: Ottawa, KS

Rural health clinic certification: CCN 173876

Legal name
OTTAWA FAMILY PHYSICIANS, CHARTERED
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 5, 1993
Last certification
May 31, 2012
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Apr 14, 1971 in KS
Enrollment address
1418 S Main
Suite 5
Ottawa, KS 66067-3544

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0448574Ottawa Family Physicians1418 South Main Ste 5, Ottawa, KS 66067AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert D Nichols Individual 5% Or Greater Direct Ownership Interest Aug 1, 2011
General Partnership Interest Aug 1, 2011
John C Gollier Individual 5% Or Greater Direct Ownership Interest Sep 24, 2010
General Partnership Interest Jul 1, 2002
Akinola E Ojeleye Individual 5% Or Greater Direct Ownership Interest Sep 24, 2010
General Partnership Interest Jul 1, 1999
Dennis P Spratt Individual 5% Or Greater Direct Ownership Interest Sep 24, 2010
General Partnership Interest Sep 1, 1980
Corporate Director Sep 24, 2010
Ellen Sinclair Webber Individual 5% Or Greater Direct Ownership Interest Sep 24, 2010
General Partnership Interest Jul 1, 1999
Denise McPheron Individual W-2 Managing Employee Sep 24, 2010
Willard B Ransom Individual 5% Or Greater Direct Ownership Interest Sep 24, 2010
General Partnership Interest Jul 26, 1982

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1477598837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 S MAIN ST",
            "address_2": "SUITE 5",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673543",
            "telephone_number": "785-242-1620",
            "fax_number": "785-242-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 S MAIN ST",
            "address_2": "SUITE 5",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673543",
            "telephone_number": "785-242-1620",
            "fax_number": "785-242-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTAWA FAMILY PHYSICIANS, CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "SPRATT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "785-242-1620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "003800",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004330B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004330E",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, KS

Sources for this page

Verify at the official NPI Registry.