NPIMap

Organization Active NPI

Wichita County Health Center

  • Rural Health Clinic/Center
  • Leoti, KS
National Provider Identifier
1497746820
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H102001
Legal business name
WICHITA COUNTY HEALTH CENTER
Practice address
211 East Earl
Leoti, KS 67861
Phone
(620) 375-2233
NPI assigned
Nov 3, 2005
Last updated
Nov 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Mrs. Amanda Baker
Title
Cfo
Phone
(620) 375-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H102001 Primary

Addresses

Primary practice location

211 East Earl
Leoti, KS 67861

Mailing address

RR 2 Box 38
211 East Earl St
Leoti, KS 67861-9504
Phone (620) 375-2233

Other identifiers 2

IdentifierTypeStateIssuer
100099560BMedicaidKS
01462OtherKSRHC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address WichitaCo.Clinic@WichitaCounty-GPHA.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040316000490 KS Part A Provider - Rural Health Clinic 7113837535 Practice locations: Leoti, KS
O20041220000555 KS Part B Supplier - Clinic/Group Practice 7113837535 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leoti, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497746820. Details of each certification follow.

Rural health clinic certification: CCN 173488

Legal name
WICHITA COUNTY HEALTH CENTER
Doing business as
WICHITA COUNTY HEALTH CENTER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 8, 1999
Last certification
Mar 18, 2014
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
211 E Earl St
Leoti, KS 67861-9620
Related CCNs
171306

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Wichita City HLTH4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Interoperability endpoints

  • Direct secure messaging: wichitaco.clinic@wichitacounty-gpha.com

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Teresa S Clark Individual Corporate DirectorCeo Oct 1, 2015
Wichita County Health Center Organization, Leoti, KS Operational/Managerial Control Mar 1, 1994 100%
Janice Campas Individual W-2 Managing EmployeeCeo Sep 30, 2015 100%

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wichita County Health CenterLeoti, KS, CCN 171306 Hospital Operational/Managerial Control (100%) Sep 16, 2015
Wichita County Health CenterLeoti, KS, CCN 17Z306 Hospital Operational/Managerial Control (100%) Sep 16, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 7

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": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1497746820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 38",
            "address_2": "211 EAST EARL ST",
            "city": "LEOTI",
            "state": "KS",
            "postal_code": "678619504",
            "telephone_number": "620-375-2233",
            "fax_number": "620-375-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EAST EARL",
            "city": "LEOTI",
            "state": "KS",
            "postal_code": "67861",
            "telephone_number": "620-375-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA COUNTY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-375-2233",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": "H102001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100099560B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC",
            "identifier": "01462",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "WichitaCo.Clinic@WichitaCounty-GPHA.com",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "211 East Earl",
            "city": "Leoti",
            "state": "KS",
            "country_code": "US",
            "postal_code": "67861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leoti, KS

Sources for this page

Verify at the official NPI Registry.