NPIMap

Organization Active NPI

Kiowa District Hospital

  • Rural Health Clinic/Center
  • Kiowa, KS
National Provider Identifier
1619960101
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KIOWA DISTRICT HOSPITAL
Practice address
1002 S 4TH St
Kiowa, KS 67070-1825
Phone
(620) 825-4131
Fax
(620) 825-4753
NPI assigned
Aug 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Steve Davis
Title
Interim Ceo
Phone
(620) 825-4131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1002 S 4TH St
Kiowa, KS 67070-1825

Mailing address

1002 S 4TH St
Kiowa, KS 67070-1825
Phone (620) 825-4131

Other identifiers 1

IdentifierTypeStateIssuer
110083OtherKSBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KiowaDistrict.Clinic@k-d-h.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041130000965 KS Part B Supplier - Clinic/Group Practice 8325020670 Receives reassigned benefits from 15 practitioners
Practice locations: Kiowa, KS

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Locations

220 S 8th St
Kiowa, KS 67070
Phone (316) 825-4121

400 N Walker Ave
Ste 250
Oklahoma City, OK 73102

Interoperability endpoints

  • Direct secure messaging: kiowadistrict.clinic@k-d-h.cernerdirect.com

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1619960101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S 4TH ST",
            "city": "KIOWA",
            "state": "KS",
            "postal_code": "670701825",
            "telephone_number": "620-825-4131",
            "fax_number": "620-825-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S 4TH ST",
            "city": "KIOWA",
            "state": "KS",
            "postal_code": "670701825",
            "telephone_number": "620-825-4131",
            "fax_number": "620-825-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIOWA DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "620-825-4131"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110083",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KiowaDistrict.Clinic@k-d-h.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1002 S 4th St",
            "city": "Kiowa",
            "state": "KS",
            "country_code": "US",
            "postal_code": "670701825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kiowa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.