NPIMap

Organization Active NPI

South Central Kansas Clinic LLC

  • Rural Health Clinic/Center
  • Arkansas City, KS
National Provider Identifier
1649682378
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTH CENTRAL KANSAS CLINIC LLC
Practice address
515 N Summit St
Arkansas City, KS 67005-2227
Phone
(620) 442-4850
Fax
(620) 441-5953
NPI assigned
May 29, 2014
Last updated
Sep 17, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Authorized official

Name
Shanon Ashley
Title
Credentialing Specialist
Phone
(316) 500-1303

Specialties & licenses 1

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

Addresses

Primary practice location

515 N Summit St
Arkansas City, KS 67005-2227

Mailing address

PO Box 1107
Arkansas City, KS 67005-1107
Phone (620) 442-4850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649682378. Details of each certification follow.

Rural health clinic certification: CCN 178599

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SOUTH CENTRAL KANSAS CLINIC LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 10, 2016
Last certification
Aug 10, 2016
Ownership / control type
2B
Facility address
515 North Summit Street
Arkansas City, KS 67005
Related CCNs
170150

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0990644South Central Kansas Clinic, LLC515 N Summit, Arkansas City, KS 67005Certificate of waiverDec 14, 2026

National Provider Directory

National Provider Directory
Part of
South Central KS Med Center

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1649682378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670051107",
            "telephone_number": "620-442-4850",
            "fax_number": "620-441-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N SUMMIT ST",
            "city": "ARKANSAS CITY",
            "state": "KS",
            "postal_code": "670052227",
            "telephone_number": "620-442-4850",
            "fax_number": "620-441-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL KANSAS CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL KANSAS REGIONAL MEDICAL CENTER",
        "enumeration_date": "2014-05-29",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "SHANON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "316-500-1303"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkansas City, KS

Sources for this page

Verify at the official NPI Registry.