Dennis Joseph Kepka, MD
Individual provider Active NPI Family Medicine Physician · Ellsworth, KS
NPI 1508866047 · NPPES record last updated Dec 14, 2009
Key facts
- NPI
- 1508866047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 04-18618 (KS)
- Practice address
- 1602 N Aylward Ave
Ellsworth, KS 67439-2541 - Phone
- (785) 472-3111
- Fax
- (785) 472-5731
- NPI assigned
- Jul 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-18618 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellsworth County Medical Center | Family Medicine | Past |
Accepting new patients |
| Ellsworth County Medical Center | Past |
Accepting new patients | |
| Ellsworth County Medical Center | Family Medicine | Past |
Accepting new patients |
| Ellsworth County Medical Center | Family Medicine | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/fca01075-736c-4da3-b816-2ead95b5dce5/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04-18618 | KS | Yes |
Addresses
Primary practice location
1602 N Aylward Ave
Ellsworth, KS 67439-2541
Mailing address
1602 N Aylward Ave
PO Box 103
Ellsworth, KS 67439-2541
Phone (785) 472-3111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060677 | Other | KS | BCBS |
| 100113160B | Medicaid | KS | |
| 622670 | Other | KS | FIRST GUARD |
Other providers in Ellsworth, KS
- Mackenzie Leigh Helman
- Mark A. Herzog
- Ashley Marie Hlad
- Sheri Jonsson
- Savannah Dawn Kelley
- Kyle Gwinner OD LLC
- Ryan T Lahey
- Emily S Lindsley
- Trevor Benjamin Lowe
- Kourtney Maisog
All providers in Ellsworth, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.