NPIMap

Organization Active NPI

Southwest Medical Center

Doing business as Canuck Medical Clinic

  • Primary Care Clinic/Center
  • Liberal, KS
National Provider Identifier
1477780955
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTHWEST MEDICAL CENTER
Doing business as
Canuck Medical Clinic
Practice address
1411 W. 15TH Street
Ste. 102
Liberal, KS 67901
Phone
(620) 624-0142
Fax
(620) 624-0142
NPI assigned
Jun 11, 2009
Last updated
Mar 17, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST MEDICAL CENTER DBA CANUCK MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Mr. Norman T Lambert
Title
Ceo/President
Phone
(620) 624-1651

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X KS
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1411 W. 15TH Street
Ste. 102
Liberal, KS 67901

Mailing address

PO Box 188
Liberal, KS 67905
Phone (620) 624-0142

Other names 1

  • Canuck Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805001105 KS Part B Supplier - Clinic/Group Practice 7517941651 Receives reassigned benefits from 80 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Meade, KS; Liberal, KS; Johnson, KS; Hugoton, KS

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
SWMC Specialty Clinic

Locations

1411 W 15th St
Ste 102
Liberal, KS 67901
Phone (620) 624-0142

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1477780955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "67905",
            "telephone_number": "620-624-0142",
            "fax_number": "620-624-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W. 15TH STREET",
            "address_2": "STE. 102",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "67901",
            "telephone_number": "620-624-0142",
            "fax_number": "620-624-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST MEDICAL CENTER DBA CANUCK MEDICAL CLINIC",
        "enumeration_date": "2009-06-11",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "620-624-1651",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canuck Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberal, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.