NPIMap

Organization Active NPI

Pratt Family Practice LLC

Doing business as Pratt Family Practice

  • Rural Health Clinic/Center
  • Pratt, KS
National Provider Identifier
1740233204
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PRATT FAMILY PRACTICE LLC
Doing business as
Pratt Family Practice
Practice address
203 Watson St
Suite 200
Pratt, KS 67124-3066
Phone
(620) 672-7422
Fax
(620) 508-6476
NPI assigned
May 18, 2006
Last updated
Jul 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Wakon Fowler, M.D.
Title
Medical Director
Phone
(620) 672-7422

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

203 Watson St
Suite 200
Pratt, KS 67124-3066

Mailing address

203 Watson St
Suite 200
Pratt, KS 67124-3066
Phone (620) 672-7422

Other identifiers 2

IdentifierTypeStateIssuer
17-8987OtherKSRHC PROVIDER #
110446OtherKSGROUP NUMBER

Other names 1

  • Pratt Family Practice Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050421000488 KS Part B Supplier - Clinic/Group Practice 6709824535 Receives reassigned benefits from 11 practitioners
Practice locations: Pratt, KS
O20120203000713 KS Part A Provider - Rural Health Clinic 6709824535 1 other NPI on this enrollment
Practice locations: Pratt, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740233204. Details of each certification follow.

Rural health clinic certification: CCN 178987

Legal name
PRATT FAMILY PRACTICE LLC
Doing business as
PRATT FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 8, 2006
Last certification
Jun 3, 2026
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Nov 5, 1998 in KS
Enrollment address
203 Watson , Suite 200
Pratt, KS 67124

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Steven R Donnenwerth Individual 5% Or Greater Direct Ownership InterestOwner Dec 31, 2021 25%
Amy Schrag Individual W-2 Managing EmployeeOffice Manager Mar 19, 2014
Operational/Managerial ControlOffice Manager Mar 19, 2014
Eric R Clarkson Individual 5% Or Greater Direct Ownership InterestOwner Dec 31, 2021 25%
Hannah K Vogt Individual 5% Or Greater Direct Ownership InterestOwner Dec 18, 2025 25%
John W Fowler Individual 5% Or Greater Direct Ownership InterestOwner/Medical Director Dec 31, 2021 25%
Corporate DirectorMedical Director Dec 31, 2021 25%

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1740233204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 WATSON ST",
            "address_2": "SUITE 200",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671243066",
            "telephone_number": "620-672-7422",
            "fax_number": "620-508-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 WATSON ST",
            "address_2": "SUITE 200",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671243066",
            "telephone_number": "620-672-7422",
            "fax_number": "620-508-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "WAKON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "620-672-7422",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC PROVIDER #",
            "identifier": "17-8987",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "110446",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pratt Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pratt, KS

Sources for this page

Verify at the official NPI Registry.