NPIMap

Organization Active NPI

Wamego Hospital Association

Doing business as Wamego Health Center and Wamego Family Clinic

  • Medicare Defined Swing Bed Hospital Unit
  • Wamego, KS
National Provider Identifier
1710970140
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H-075-002 Issued in KS
Legal business name
WAMEGO HOSPITAL ASSOCIATION
Doing business as
Wamego Health Center and Wamego Family Clinic
Practice address
711 Genn Dr
Wamego, KS 66547
Phone
(785) 456-2295
Fax
(785) 456-9467
NPI assigned
Aug 31, 2005
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Steve LandNPI 1508991787
Title
Administrator
Phone
(785) 456-2295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H-075-002 KS Primary

Addresses

Primary practice location

711 Genn Dr
Wamego, KS 66547

Mailing address

8200 Thorn Dr
Wichita, KS 67226-2709
Phone (316) 268-5178

Other identifiers 1

IdentifierTypeStateIssuer
001127OtherKSBLUE CROSS SWING #

Other names 1

  • Wamego Health Center and Wamego Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070222000500 KS Part A Provider - Critical Access Hospital 5395656086 Practice locations: Wamego, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710970140. Details of each certification follow.

Hospital certification: CCN 17Z337

Legal name
WAMEGO HOSPITAL ASSOCIATION
Doing business as
WAMEGO HEALTH CENTER
Organization structure
OtherNon-profit
Incorporated
Jun 7, 2002 in KS
Enrollment address
711 Genn Dr
Wamego, KS 66547-1179
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Wamego City Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8200 Thorn Dr
Wichita, KS 67226
Phone (316) 719-3279

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Robert Copple Individual Corporate Director Jan 1, 2019
Ascension Via Christi Hospital Manhattan Inc Organization, Manhattan, KS Non-profit Operational/Managerial Control Jul 1, 2002 51%
Dwight Faulkner Individual Corporate Director Jan 1, 2019
Mark Wilkerson Individual Corporate Director Jan 1, 2019
Brian Howells Individual Corporate Director Jan 1, 2019
Segen Elizabeth S Chase Individual Corporate Director Sep 6, 2022
Lanny Bosse Individual Corporate Director Jan 1, 2019
Michael McCullough Individual Corporate Director Jan 1, 2019
Thomas Beem Individual Corporate Director Jan 1, 2019
Dirk Daveline Individual Corporate Director Jan 1, 2019
Ryan Jennings Kueker Individual Corporate Director Sep 6, 2022
Jennifer Goehring Individual Corporate Director Jan 1, 2019
Stephanie Shaffer Individual W-2 Managing Employee Sep 6, 2022

Owners & managing parties with NPI records 5

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1710970140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 THORN DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262709",
            "telephone_number": "316-268-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 GENN DR",
            "city": "WAMEGO",
            "state": "KS",
            "postal_code": "66547",
            "telephone_number": "785-456-2295",
            "fax_number": "785-456-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAMEGO HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-456-2295"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": "H-075-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SWING #",
            "identifier": "001127",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wamego Health Center and Wamego Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wamego, KS

Sources for this page

Verify at the official NPI Registry.