NPIMap

Organization Active NPI

Coffey County Hospital

  • Family Medicine Physician
  • Burlington, KS
National Provider Identifier
1508941865
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COFFEY COUNTY HOSPITAL
Practice address
801 N 4TH St
Burlington, KS 66839-2602
Phone
(620) 364-2121
Fax
(620) 364-4525
NPI assigned
Oct 26, 2006
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Stacy Nicole Augustyn
Title
Ceo
Phone
(620) 364-2121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

801 N 4TH St
Burlington, KS 66839-2602

Mailing address

801 N 4TH St
Burlington, KS 66839-2602
Phone (620) 364-2121

Other identifiers 2

IdentifierTypeStateIssuer
180038OtherKSBLUE CROSS BLUE SHEILD
9842OtherKSBLUE CROSS & BLUE SHIELD

Other names 1

  • Coffey County Hospital Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000478 KS Part B Supplier - Clinic/Group Practice 4981598653 Receives reassigned benefits from 43 practitioners
Practice locations: Burlington, KS

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • County of Coffey

    dba Coffey Co Health Dept

    • State or Local Public Health Clinic/Center
    • Burlington, KS
    • NPI 1285731406

    Member Of

    NPD member

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Coffey County HospitalBurlington, KS, CCN 171385 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Coffey County HospitalBurlington, KS, CCN 17Z385 Hospital Other (100%) Jan 1, 2017
Coffey County Medical Center RHCBurlington, KS, CCN 173982 Rural health clinic 5% Or Greater Direct Ownership Interest (75%) Jan 1, 1966
Waverly Medical ClinicWaverly, KS, CCN 173983 Rural health clinic Operational/Managerial Control (100%) Apr 16, 1991
Yates Center Medical Center Rural Health ClinicYates Center, KS, CCN 178559 Rural health clinic Operational/Managerial Control (100%) Jul 18, 2018

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1508941865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N 4TH ST",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668392602",
            "telephone_number": "620-364-2121",
            "fax_number": "620-364-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N 4TH ST",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668392602",
            "telephone_number": "620-364-2121",
            "fax_number": "620-364-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEY COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "AUGUSTYN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "620-364-2121"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "180038",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "9842",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coffey County Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Coffey County Hospital",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Burlington, KS

Sources for this page

Verify at the official NPI Registry.