NPIMap

Organization Active NPI

Susan B. Allen Memorial Hospital

Doing business as Susan B. Allen Memorial Hospital Home Medical Equipment

  • Durable Medical Equipment & Medical Supplies
  • El Dorado, KS
National Provider Identifier
1710086632
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUSAN B. ALLEN MEMORIAL HOSPITAL
Doing business as
Susan B. Allen Memorial Hospital Home Medical Equipment
Practice address
720 W Central Ave
El Dorado, KS 67042-2112
Phone
(316) 322-4549
Fax
(316) 321-4912
NPI assigned
Sep 21, 2006
Last updated
May 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Melissa Hall
Title
Ceo
Phone
(316) 322-4558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

720 W Central Ave
El Dorado, KS 67042-2112

Mailing address

720 W Central Ave
El Dorado, KS 67042-2112
Phone (316) 321-3300

Other identifiers 2

IdentifierTypeStateIssuer
100009270AMedicaidKS
48582OtherKSBLUE CROSS BLUE SHIELD

Other names 1

  • Susan B. Allen Memorial Hospital Home Medical Equipment Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930065827 KS DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - HospitalDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 7719898980 Practice locations: El Dorado, KS

Other NPIs with the same Medicare PAC ID 4

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Susan B Allen Memorial Hospital720 W Central Ave, El Dorado, KS 67042-2112(316) 322-4589 Commodes, Urinals, Bedpans|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Wheelchair Seating/Cushions|Orthoses: Custom Fabricated|Orthoses: Off-The-Shelf|Continuous Positive Airway Pressure (CPAP) Devices|Nebulizer Equipment and/or Supp… Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Lyle E Baade PHD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

700 W Central Ave
Ste 110
El Dorado, KS 67042
Phone (316) 321-5211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1710086632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W CENTRAL AVE",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422112",
            "telephone_number": "316-321-3300",
            "fax_number": "316-321-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W CENTRAL AVE",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422112",
            "telephone_number": "316-322-4549",
            "fax_number": "316-321-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN B. ALLEN MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "316-322-4558"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009270A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48582",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan B. Allen Memorial Hospital Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Susan B. Allen Memorial Hospital Home Medical Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Dorado, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.