County of Rawlins
Organization Active NPI Health Service Clinic/Center · Atwood, KS
NPI 1669464087 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1669464087
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- License
- 48-6029925 (KS)
- Legal business name
- COUNTY OF RAWLINS
- Practice address
- 216 S. 4TH Street
Atwood, KS 67730 - Phone
- (785) 626-3968
- Fax
- (785) 626-3876
- NPI assigned
- Aug 22, 2005
- Organization subpart
- No
Authorized official
- Name
- Mary K Clark
- Title
- Administrator
- Phone
- (785) 626-3968
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 1
Member organizations 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0648393 | Rawlins County Public Health Dept | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Rawlins County Health Center |
Hospital | 5% Or Greater Direct Ownership Interest (5%) | Oct 31, 1995 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240520002643 | KS | Part B Supplier - Mass Immunization (Roster Biller Only) | 3274443239 | Practice locations: Atwood, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 48-6029925 | KS | Yes |
Addresses
Primary practice location
216 S. 4TH Street
Atwood, KS 67730
Mailing address
216 S. 4TH Street
Atwood, KS 67730
Phone (785) 626-3968
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012743 | Other | KS | BLUE CROSS BLUE SHIELD |
| 100091430A | Medicaid | KS |
Other names
- Rawlins County Public Health Department
Other providers in Atwood, KS
- Atwood Pharmacy Inc
- Mary A Augustyn
- Breathe-in, Inc
- Mollie Jill Bretz
- County of Rawlins
- Lyle A Dixson
- Valerie Elliott
- April J Green
- James Edward Hampton
- Kyle Frank Herspring
All providers in Atwood, KS · Health Service Clinic/Center in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.