Freeman Fort Scott Hospital Inc
Organization Active NPI Hospitalist Physician · Fort Scott, KS
NPI 1669290342 · NPPES record last updated Jul 8, 2025
Key facts
- NPI
- 1669290342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hospitalist Physician 208M00000X
- Legal business name
- FREEMAN FORT SCOTT HOSPITAL INC
- Practice address
- 401 Woodland Hills Blvd
Fort Scott, KS 66701-8797 - Phone
- (417) 347-1111
- NPI assigned
- Oct 1, 2024
- Organization subpart
- No
Authorized official
- Name
- Steven W Graddy
- Title
- Cfo
- Phone
- (417) 347-6678
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 2
Practitioners 5
-
Katrina M. Burke, M.D.
-
Pankaj Gugnani, M.D.
-
Ricky Kellenberger, D.O
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250922000847 | KS | Part B Supplier - Clinic/Group Practice | 2668970385 |
Receives reassigned benefits from 16 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Scott, KS |
National Provider Directory
- Tax ID family
- Freeman Fort Scott Hosp Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
401 Woodland Hills Blvd
Fort Scott, KS 66701-8797
Mailing address
PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-4662
Other names
- FREEMAN FORT SCOTT PHYSICIAN GROUP
Other providers in Fort Scott, KS
- W. J. Bryan Foxx, II
- Franklin House
- Franklinhouse
- Freeman Fort Scott Hospital Inc
- Freeman Fort Scott Hospital Inc
- Ft Scott Eye Center P.a.
- Ft Scott Eye Center P.a.
- Ft Scott Surgery Center LLC
- Irvin Garcia-Augur
- Crystal Star Garcia
All providers in Fort Scott, KS · Hospitalist Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.