NPIMap

Organization Active NPI

St Rose Healthcare Center LLC

  • Ambulatory Surgical Clinic/Center
  • Great Bend, KS
National Provider Identifier
1588066146
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ST ROSE HEALTHCARE CENTER LLC
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 792-2511
NPI assigned
Sep 25, 2014
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. John H Jeter, M.D.NPI 1609043660
Title
President & Ceo
Phone
(785) 623-5523

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

3515 Broadway Ave
Great Bend, KS 67530-3633

National Provider Directory

National Provider Directory
Tax ID family
St Rose Healthcare Center LLC4 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1588066146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ROSE HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "785-623-5523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.