Medicalodges, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N063006 Issued in KS

Legal business name

MEDICALODGES, INC.

Doing business as

Medicalodges Coffeyville

Practice address

720 W 1St St
Coffeyville, KS 67337-3854

Phone

(620) 251-3705

Fax

(620) 251-2410

NPI assigned

Mar 23, 2006

Last updated

Oct 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cathy W Fisher

Title

Chief Financial Officer

Phone

(620) 251-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medicalodges Coffeyville Doing business as

Member of 1

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

• Medicalodges, Inc.

  dba Medicalodges Post Acute Care Center

  • Skilled Nursing Facility
  • Kansas City, KS
  • NPI 1790872620

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1609836899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W 1ST ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373854",
            "telephone_number": "620-251-3705",
            "fax_number": "620-251-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W 1ST ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373854",
            "telephone_number": "620-251-3705",
            "fax_number": "620-251-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALODGES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "620-251-6700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "N063006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108830A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicalodges Coffeyville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Laine McGuire, FNP
• Michelle A. McGuirk, MD
• Carolyn M McIlwain, CCC-SLP
• Trina McIntosh
• Medicalodges, Inc.
• Shaun Lanceine Meek, LCMFT
• Diane Mendoza
• Kerry Louise Mersberg, DC CPED
• Joseph Maylen Miller, MSW DCSW LSCSW
• Tiffany Renae Miller, PHARMD

• Skilled Nursing Facility in Coffeyville, KS
• Providers in Coffeyville, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.