NPIMap

Individual provider Active NPI

Racquel Stucky, D.O.

  • Family Medicine Physician
  • Garden City, KS
National Provider Identifier
1497136220
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94-08687 Issued in KS
Practice address
911 N Main St
Garden City, KS 67846-5561
Phone
(620) 276-8201
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-08687 KS Primary

Addresses

Primary practice location

911 N Main St
Garden City, KS 67846-5561

Mailing address

712 Saint John St
Garden City, KS 67846-5128
Phone (620) 275-1766

Other practice location 1

712 Saint John St
Garden City, KS 67846-5128
Phone (620) 275-1176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918000798 KS Practitioner - Family Practice 5294049391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonspirit Kansas IncGroup PAC ID 4789595844, 62 clinicians

Practice addresses (Care Compare)

100 W Ross Blvd
Suite 1B
Dodge City, KS 67801-7217
Phone (620) 371-5576

911 N Main St
SCHP Plaza Medical
Garden City, KS 67846-5561
Phone (620) 276-8201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
94-08687KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonspirit Kansas, Inc. Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Commonspirit Kansas, Inc. Current Accepting new patients
St Catherine Hospital Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Commonspirit Kansas, Inc. Family Medicine Past Accepting new patients
St. Catherine Hospital Family Medicine Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

100 W Ross Blvd
Ste 1B
Dodge City, KS 67801
Phone (620) 371-5576

911 N Main St
Garden City, KS 67846
Phone (316) 276-8201

401 E Spruce St
Garden City, KS 67846
Phone (620) 272-2222

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1497136220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 SAINT JOHN ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465128",
            "telephone_number": "620-275-1766",
            "fax_number": "620-275-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N MAIN ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678465561",
            "telephone_number": "620-276-8201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 Saint John St",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "KS",
            "postal_code": "678465128",
            "country_code": "US",
            "telephone_number": "620-275-1176",
            "fax_number": "620-275-4728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCKY",
        "first_name": "RACQUEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-08687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.