NPIMap

Organization Active NPI

Northeast Kansas Center for Health and Wellness, Inc.

  • Family Medicine Physician
  • Horton, KS
National Provider Identifier
1750325197
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H-007-002 Issued in KS
Legal business name
NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS, INC.
Practice address
240 W 18TH St
Horton, KS 66439-1245
Phone
(785) 486-2642
Fax
(785) 486-2842
NPI assigned
Jun 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Dale A. White
Title
Ceo
Phone
(785) 486-2642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H-007-002 KS Primary

Addresses

Primary practice location

240 W 18TH St
Horton, KS 66439-1245

Mailing address

240 W 18TH St
Horton, KS 66439-1245
Phone (785) 486-2642

Other identifiers 8

IdentifierTypeStateIssuer
426996OtherKSBLUE SHIELD
664990OtherKSFIRST GUARD HEALTH PLAN
161636OtherKSBLUE SHIELD
426980OtherKSBLUE SHIELD
042154OtherKSBLUE SHIELD
105445OtherKSBLUE SHIELD
928432OtherKSFIRST GUARD HEALTH PLAN
927587OtherKSFIRST GUARD HEALTH PLAN

Other names 1

  • Physician Hospital Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Kansas Center for Health and Wellness Inc8 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750325197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W 18TH ST",
            "city": "HORTON",
            "state": "KS",
            "postal_code": "664391245",
            "telephone_number": "785-486-2642",
            "fax_number": "785-486-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W 18TH ST",
            "city": "HORTON",
            "state": "KS",
            "postal_code": "664391245",
            "telephone_number": "785-486-2642",
            "fax_number": "785-486-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "785-486-2642",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "H-007-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "426996",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD HEALTH PLAN",
            "identifier": "664990",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "161636",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "426980",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "042154",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "105445",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD HEALTH PLAN",
            "identifier": "928432",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST GUARD HEALTH PLAN",
            "identifier": "927587",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physician Hospital Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Horton, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.