Jefferson County Memorial Hospital, Inc
Organization Active NPI Physician Assistant · Winchester, KS
NPI 1750354908 · NPPES record last updated Sep 9, 2021
Key facts
- NPI
- 1750354908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- Legal business name
- JEFFERSON COUNTY MEMORIAL HOSPITAL, INC
- Practice address
- 408 Delaware St
Winchester, KS 66097-4003 - Phone
- (913) 774-4340
- Fax
- (913) 774-3379
- NPI assigned
- Feb 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Lamont Cook
- Title
- Ceo
- Phone
- (913) 774-4340
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 2
Practitioners 23
-
Judee Sara Marie Cordell, FNP-C
-
Shelby Sprang, DNP, FNP-C
-
Cathryn Wieck, APRN
-
Katherine Margaret Thornburgh Bayer, BSN, APRN-S, DNP-S
-
Gary B. Morsch, M.D.
-
Blake Gordon Phipps, M.D.
-
Ronald R Ross, PA-C
-
Heather Regann Aranda, APRN
-
Edward Theodore Duensing, NP-C
-
Samuel Y Ho, M.D.
-
Yolanda Huet-Vaughn, M.D.
-
Cooper L Nickel, M.D.
-
Alexander Overbey, DNP-C
-
Mary L Rardin, MD
-
Lorelei M Sunderland, ARNP
-
Katherine M. Walker, APRN
-
Ariel Zachariah, DNP, FNP-C
-
Deborah Dawn McKibben, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050215000085 | KS | Part B Supplier - Clinic/Group Practice | 6002868445 |
Receives reassigned benefits from 10 practitioners 4 other NPIs on this enrollment Practice locations: Winchester, KS; Basehor, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | Yes |
Addresses
Primary practice location
408 Delaware St
Winchester, KS 66097-4003
Mailing address
408 Delaware St
Winchester, KS 66097-4003
Phone (913) 774-4340
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100080370F | Medicaid | KS |
Other names
- Jefferson Medical Clinic
Other providers in Winchester, KS
- Joan T Foster
- Jefferson County Memorial Hospital
- Jefferson County Memorial Hospital Inc
- Jefferson County Memorial Hospital, Inc
- Jefferson County Memorial Hospital, Inc
- Jefferson County Memorial Hospital, Inc.
- Jefferson County Memorial Hospital, Inc.
- Jefferson County North Usd339
- Michael F Law
- Geraldine Loween Long
All providers in Winchester, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.