NPIMap

Organization Active NPI

Heartland Medical Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Lawrence, KS
National Provider Identifier
1689367252
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEARTLAND MEDICAL CLINIC, INC
Practice address
534 Michigan Street
Lawrence, KS 66044
Phone
(785) 841-7297
Fax
(785) 856-0375
NPI assigned
May 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

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

Authorized official

Name
Julie Meredith Branstrom
Title
Ceo
Phone
(785) 841-7297

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

534 Michigan Street
Lawrence, KS 66044

Mailing address

1312 W 6TH St
Lawrence, KS 66044-2219
Phone (785) 841-7297

Other names 1

  • Heartland Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040419001521 KS Part B Supplier - Clinic/Group Practice 2769477645 Receives reassigned benefits from 43 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrence, KS
O20241016001740 KS Part A Provider - Federally Qualified Health Center (FQHC) 2769477645 Practice locations: Lawrence, KS

Federally qualified health center certification: CCN 171027

Legal name
HEARTLAND MEDICAL CLINIC INC
Doing business as
HEARTLAND COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2024
Last certification
Oct 2, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
534 Michigan St
Lawrence, KS 66044-1745

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Heartland Medical Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1803 W 6th St
Lawrence, KS 66044
Phone (785) 841-7297

1312 W 6th St
Lawrence, KS 66044
Phone (785) 841-7297

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jay Pryor Individual Corporate DirectorSecretary Aug 1, 2018
Brad Koehler Individual Corporate DirectorBoard Chair Feb 1, 2018
James Moore Individual Corporate DirectorBoard Member Apr 1, 2023
Gladys Power Individual Corporate DirectorBoard Member Oct 1, 2023
Laura M Canelos-Ramon Individual Corporate DirectorBoard Member Jun 1, 2021
Denise Ballard Individual Corporate DirectorBoard Member Feb 1, 2024
Susan Thomas Individual Corporate DirectorBoard Member Jul 1, 2020
William Joseph Anderson Individual Corporate DirectorBoard Member Apr 1, 2024
Paula Martin Individual Corporate Director Aug 1, 2022
Julie Branstrom Individual Corporate DirectorCeo Jan 1, 2022
W-2 Managing EmployeeAd; Jan 1, 2022
Quinten Rials Individual Corporate DirectorBoard Member Mar 1, 2024
Anne B Owen Individual Corporate DirectorVice Chair Mar 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751155200000",
    "number": "1689367252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 W 6TH ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442219",
            "telephone_number": "785-841-7297",
            "fax_number": "785-856-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 MICHIGAN STREET",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "66044",
            "telephone_number": "785-841-7297",
            "fax_number": "785-856-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A",
        "authorized_official_last_name": "BRANSTROM",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "MEREDITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-841-7297"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.