NPIMap

Organization Active NPI

Ninnescah Valley Health Systems Inc

Doing business as Kingman Healthcare Center Family Clinic

  • Rural Health Clinic/Center
  • Kingman, KS
National Provider Identifier
1508253501
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NINNESCAH VALLEY HEALTH SYSTEMS INC
Doing business as
Kingman Healthcare Center Family Clinic
Practice address
750 W D Ave
Kingman, KS 67068-1266
Phone
(620) 532-0295
Fax
(855) 483-0002
NPI assigned
Apr 17, 2015
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Lacy Drosselmeyer
Title
Compliance Specialist
Phone
(620) 532-0281

Specialties & licenses 1

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

Addresses

Primary practice location

750 W D Ave
Kingman, KS 67068-1266

Mailing address

750 W D Ave
Kingman, KS 67068-1266
Phone (620) 532-0295

Other names 1

  • KINGMAN HEALTHCARE CENTER FAMILY CLINIC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407000038 KS Part B Supplier - Clinic/Group Practice 5799683694 Receives reassigned benefits from 41 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cunningham, KS; Kingman, KS
O20150505000953 KS Part A Provider - Rural Health Clinic 5799683694 Receives reassigned benefits from 1 practitioner
Practice locations: Kingman, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508253501. Details of each certification follow.

Rural health clinic certification: CCN 178588

Legal name
NINNESCAH VALLEY HEALTH SYSTEMS INC
Doing business as
KINGMAN HEALTHCARE CENTER FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2015
Last certification
Dec 12, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 6, 1968 in KS
Enrollment address
750 W D Ave
Kingman, KS 67068-1266
Related CCNs
171378

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Thad Turner Individual Corporate DirectorCfo Mar 1, 2018
W-2 Managing EmployeeCfo Mar 1, 2018
Operational/Managerial ControlCfo Mar 1, 2018
Preston M Sauers Individual Corporate OfficerCeo Apr 21, 2021
W-2 Managing EmployeeCeo Apr 21, 2021
Operational/Managerial ControlCeo Apr 21, 2021
Ninnescah Valley Health Systems Inc Organization, Kingman, KS Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 27, 2015 100%
Lacy Drosselmeyer Individual Corporate DirectorDirector of Clinics Aug 1, 2016
W-2 Managing EmployeeDirector of Clinics Aug 1, 2016
Operational/Managerial ControlDirector of Clinics Aug 1, 2016

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Cunningham ClinicCunningham, KS, CCN 178587 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 6, 2015

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1508253501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W D AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681266",
            "telephone_number": "620-532-0295",
            "fax_number": "855-483-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W D AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681266",
            "telephone_number": "620-532-0295",
            "fax_number": "855-483-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINNESCAH VALLEY HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "DROSSELMEYER",
        "authorized_official_first_name": "LACY",
        "authorized_official_title_or_position": "COMPLIANCE SPECIALIST",
        "authorized_official_telephone_number": "620-532-0281"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KINGMAN HEALTHCARE CENTER FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KINGMAN HEALTHCARE CENTER FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, KS

Sources for this page

Verify at the official NPI Registry.