NPIMap

Individual provider Active NPI

Kali Rubenthaler-Brunkhardt, DO

  • Family Medicine Physician
  • Goodland, KS
National Provider Identifier
1679893788
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0535360 Issued in KS
Practice address
106 Willow Rd
Goodland, KS 67735-1518
Phone
(785) 890-4012
Fax
(785) 890-6077
NPI assigned
Jun 11, 2010
Last updated
May 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7419 KS
Family Medicine Physician 207Q00000X 0535360 KS Primary

Addresses

Primary practice location

106 Willow Rd
Goodland, KS 67735-1518

Mailing address

106 Willow Rd
Goodland, KS 67735-1518
Phone (785) 890-4012

Other identifiers 2

IdentifierTypeStateIssuer
200750580CMedicaidKS
1679893788OtherKSBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191202000643 NE Practitioner - Family Practice 9133382914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2900 W E St
North Platte Care Center
North Platte, NE 69101-1803
Phone (308) 534-2200

4000 W Philip Ave
Linden Court
North Platte, NE 69101-0305
Phone (308) 532-5774

601 W Leota St
North Platte, NE 69101-6525

625 W William Ave
North Platte, NE 69101-0026

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7419KSMDSocial Worker
0535360KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Sep 24, 2019 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Goodland Regional Medical Center Past Accepting new patients
VSL North Platte Court LLC Past Accepting new patients

Locations

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

625 W William Ave
North Platte, NE 69101
Phone (308) 289-3574

625 W William Ave
#100
North Platte, NE 69101
Phone (308) 568-3580

625 W William Ave
#230
North Platte, NE 69101

625 W William Ave
Ste 230
North Platte, NE 69101
Phone (308) 534-4440

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Linden CourtNorth Platte, NE, CCN 285083 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control		 Dec 2, 2019
Dec 2, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1679893788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-4012",
            "fax_number": "785-890-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WILLOW RD",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677351518",
            "telephone_number": "785-890-4012",
            "fax_number": "785-890-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENTHALER-BRUNKHARDT",
        "first_name": "KALI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "7419",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0535360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200750580C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1679893788",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodland, KS

Sources for this page

Verify at the official NPI Registry.