Augusta Family Practice

Organization Active NPI Family Nurse Practitioner · Augusta, KS

NPI 1619375342 · NPPES record last updated Dec 11, 2014

Key facts

NPI
1619375342
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
5376107 (KS)
Legal business name
AUGUSTA FAMILY PRACTICE
Practice address
1306 State St
Augusta, KS 67010-1126
Phone
(316) 775-9191
Fax
(316) 775-0348
NPI assigned
Dec 11, 2014
Organization subpart
No

Authorized official

Name
Amanda Johnson
Title
Coo
Phone
(316) 775-9191

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Augusta Family Practice (2 organizations share this tax ID)

Locations

1306 State St
Augusta, KS 67010
Phone (316) 775-9191

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 5376107 KS Yes

Addresses

Primary practice location

1306 State St
Augusta, KS 67010-1126

Mailing address

1306 State St
Augusta, KS 67010-1126
Phone (316) 775-9191

Other identifiers

IdentifierTypeStateIssuer
100359330BMedicaidKS
100359330AMedicaidKS

Other providers in Augusta, KS

All providers in Augusta, KS · Family Nurse Practitioner in Kansas

Sources for this page

Verify at the official NPI Registry.